Pregnancy after kidney transplantation: high rates of maternal
            complications

Cândido, Cristina; Cristelli, Marina Pontello; Fernandes, Ana Raquel; Lima, A. F.; Viana, Laila Almeida; Sato, Jussara Leiko; Sass, Nelson; Tedesco‐Silva, Hélio; Medina-Pestana, J.O.

doi:10.5935/0101-2800.20160067

Cited by 14 publications

(19 citation statements)

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“…Our cesarean rates were high, mostly due to the worsening of maternal conditions. While another two Brazilian studies seem to have lower cesarean section rates, 17,18 a most recent European study presented rates similar to ours. 19 Having previous kidney transplantation is not a reason to perform a cesarean section, and induction of vaginal delivery is possible in the majority of cases.…”

Section: Discussionsupporting

confidence: 87%

Pregnancy Among Women with Kidney Transplantation: A 20-Years Single-Center Registry

Mariano

Guida

Sousa

et al. 2019

Rev Bras Ginecol Obstet

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Objective To assess maternal and perinatal outcomes in pregnancies after kidney transplantation in a tertiary center in Brazil. Methods Retrospective cohort of pregnancies in women with kidney transplantation at the Universidade Estadual de Campinas, from January 1995 until December 2017. Medical charts were reviewed, and maternal and perinatal outcomes were described as means and frequencies. Renal function and blood pressure were evaluated during pregnancy and postpartum. Results A total of 22 women had at least 1 pregnancy during the considered time interval, and 3 of them had > 1 pregnancy, totalizing 25 pregnancies. The mean age at transplantation was of 24.6 ± 4.2 years old, and the mean time interval until pregnancy was of 67.8 ± 46.3 months. The most frequent complication during pregnancy was hypertension, which affected 11 (64.7%) women. The gestational age at delivery was 34.7 ± 4 weeks, and 47% of these pregnancies were preterm (< 37 weeks). A total of 88.2% of the women delivered by cesarean section. Renal function, measured by serum creatinine, remained stable during pregnancy, and the systolic blood pressure increased significantly, while the diastolic blood pressure did not differ during pregnancy. Conclusion Pregnancy after kidney transplantation is a rare event. Pre-eclampsia and prematurity were frequent complications, and cesarean section rates were very high. A specialized antenatal and postpartum care with a multiprofessional approach and continuous monitoring of graft function are essential for the early diagnosis of complications and improved outcomes.

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Section: Discussionsupporting

confidence: 87%

Pregnancy Among Women with Kidney Transplantation: A 20-Years Single-Center Registry

Mariano

Guida

Sousa

et al. 2019

Rev Bras Ginecol Obstet

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“…A small significant rise in SCr within 2 years after delivery as described in 87 KT recipients derived from 3 studies. 30 , 43 , 44 Possibly, this might be caused by physiological changes after pregnancy or restart of medication such as ACE inhibitors. On the contrary, this could be the result of high rate of risk factors in the study population (65.9% hypertension, 36.5% SCr >1.5 mg/dL before pregnancy 43 ), which makes these women more prone for deterioration of graft function or even GL.…”

Section: Discussionmentioning

confidence: 99%

Long-term Graft Survival and Graft Function Following Pregnancy in Kidney Transplant Recipients: A Systematic Review and Meta-analysis

et al. 2019

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“…Otra complicación presente en las mujeres receptoras de TR es la diabetes gestacional, aunque en los artículos revisados el riesgo de desarrollarla es bajo en comparación con el resto de complicaciones maternas 24,27,29,[31][32][33]35,38 .…”

Section: Los Fármacos Inmunosupresores Más Utilizados Antes Del Embar...unclassified

“…Respecto a los parámetros bioquímicos, desde el inicio hasta el tercer trimestre de embarazo se produce un aumento significativo del nivel de creatinina sérica en la población 26,27,29,32,39 .…”

Section: Los Fármacos Inmunosupresores Más Utilizados Antes Del Embar...unclassified

Embarazo y trasplante renal. Una revisión sistemática

et al. 2021

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Introducción: El trasplante renal es la mejor opción como tratamiento renal sustitutivo, por sus múltiples beneficios, permitiendo además a las mujeres con enfermedad renal crónica la posibilidad de embarazo y de una gestación exitosa.Objetivo: Conocer y sintetizar la producción científica más actualizada sobre el embarazo en mujeres con trasplante renal.Metodología: Se realizó una revisión sistemática siguiendo las recomendaciones de la declaración PRISMA, en las bases de datos PubMed, ProQuest, Scielo y Scopus. La estrategia de búsqueda se estableció con los siguientes descriptores: “pregnancy” y “kidney transplantation”. Se incluyeron artículos originales y revisiones sistemáticas, en español e inglés publicados entre 2015 y 2020.Resultados: Se seleccionaron 18 artículos. Se encontró una edad media de las mujeres trasplantadas en el momento del parto entre los 30 y 34 años y un tiempo medio entre el trasplante renal y el embarazo de 4,2 años. Las complicaciones más frecuentes en la madre fueron la preeclampsia, la hipertensión arterial inducida por el embarazo y la infección del tracto urinario, así como un aumento de la creatinina sérica y proteinuria. La mayoría de los embarazos terminaron en cesáreas y, entre los nacidos vivos, existió un gran número de prematuros.Conclusiones: El embarazo en mujeres con trasplante renal resulta exitoso siempre que la función renal se mantenga estable y no aparezcan complicaciones. Las complicaciones más frecuentes durante el embarazo son la hipertensión y la preeclampsia. La complicación más frecuente en el neonato es la prematuridad.

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Pregnancy after kidney transplantation: high rates of maternal complications

Abstract: Although the sample is limited, the number of miscarriages was higher than in the general population, with high rates of maternal complications. Sustained increase of creatinine suggests increased risk of graft loss in long-term.

Cited by 14 publications

References 0 publications

Pregnancy Among Women with Kidney Transplantation: A 20-Years Single-Center Registry

Pregnancy Among Women with Kidney Transplantation: A 20-Years Single-Center Registry

Long-term Graft Survival and Graft Function Following Pregnancy in Kidney Transplant Recipients: A Systematic Review and Meta-analysis

Embarazo y trasplante renal. Una revisión sistemática

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