Successful Pregnancies in Kidney Transplant Recipients: Experience of the National Kidney Transplant Program From Uruguay
| Autor: | Oscar Noboa, L. Curi, Sergio Orihuela, Francisco González-Martínez, S. San Román, Ricardo Silvariño, Marcelo Nin |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology Renal function Abortion 03 medical and health sciences Young Adult 0302 clinical medicine Pregnancy medicine Humans 030212 general & internal medicine Dialysis Kidney transplantation Retrospective Studies Gynecology Postoperative Care Transplantation business.industry Obstetrics Cesarean Section Infant Newborn Pregnancy Outcome medicine.disease Kidney Transplantation Transplant Recipients Abortion Spontaneous Pregnancy Complications Low birth weight Gestation Kidney Failure Chronic Premature Birth Uruguay Surgery Female Pancreas Transplantation medicine.symptom Preconception Care business Infant Premature |
| Zdroj: | Transplantation proceedings. 48(2) |
| ISSN: | 1873-2623 |
| Popis: | Background Renal transplantation increases the possibilities of pregnancy in women of reproductive age. The course of pregnancy was analyzed retrospectively in patients with kidney or kidney-pancreas transplant, surveying maternal-fetal or renal graft complications and the relation with pre-pregnancy renal function. Methods A cohort that includes all the kidney transplant recipients who went through pregnancy in Uruguay in a period of 28 years is described. Forty pregnancies in 32 patients were registered; the average time between the kidney transplant and the beginning of the gestation period was 47 months. From the total gestations, 10 abortions, 1 neonatal death, and 1 fetal demise were registered. From the remaining pregnancies, we highlight prematurity (18/29) and low birth weight (14/21). Twenty-nine in 30 pregnancies ended in cesarean section; in 8 of 30, pre-eclampsia diagnosis was performed. Acute rejection was diagnosed in 2 of 30 pregnancies, both undergoing their first post-transplant year. Results Two patients required dialysis throughout the pregnancy because of progress into severe renal insufficiency. Higher obstetric perinatal morbidity and renal function deterioration was related to lower pre-pregnancy glomerular filtration rate (GFR). Conclusions A successful pregnancy is possible in transplant recipients, yet there are risks of prematurity, low birth weight, and abortion. A lower GFR before pregnancy was associated with poorer maternal and perinatal results as shown in the different series. |
| Databáze: | OpenAIRE |
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