Pregnancy after renal transplantation: Experience in singapore general hospital

Pregnancy after renal transplantation – a five‐yr single‐center experience

“…Clinical complications are almost inevitable in pregnant renal transplant recipients, (hypertension, urinary tract infection, anemia and diabetes) (1, 2, 4, 9) and in our series chronic hypertension was the most common. Most patients had a good response to only one antihypertensive medication (alfa‐methyldopa), while some needed more than one medication and multiple hospital admissions to stabilize and control their blood pressure.…”

“…Sexual function improves after renal transplantation and literature reports an incidence of pregnancy of about 1:50 (1, 2), so the possibility of conceiving must be considered by all patients who must therefore use contraception as pregnancy could occur even in the first month after grafting (6). Then criteria for pre‐pregnancy planning have been recommended: good general health for approximately two yr after transplantation, absent or minimal proteinuria, mild or well‐controlled hypertension, serum creatinine levels <180 μ mol/L or 2 mg/dL (preferable if <125 μ mol/L or 1.4 mg/dL), and absence of pelvicalyceal distension.…”

“…Special attention to gestational diabetes is needed because of chronic use of glucocorticoids (2). We found only two patients with this problem (4%) and we had no difficulty controlling these cases.…”

Pregnancy in patients with previous successful renal transplantation

“…Because the patient's blood glucose level could not be adequately controlled despite intensive insulin administration, steroid therapy was stopped in the 34th week of pregnancy. It is reported that abnormal glucose tolerance test results occur in up to 13.8% of pregnant transplant recipients whose immunosuppressive therapy consists of corticosteroids [17,18]. However, not only corticosteroids, but nearly all immunosuppressive drugs are associated with glucose intolerance.…”

Pregnancy with Medical Disorders: the Challenge to Meet

“…Successful medical treatments, renal dialysis or transplantation have made childbearing a reality for these women. [4][5][6] Their pregnancies, however, can sometimes bring on changes beyond the limit of their physiological responses and cause decompensations which lead to severe morbidity or mortality of either the parturient or the fetus or both.…”