Pregnancy in Renal Allograft Recipients

Fine, Richard Ν.

doi:10.1159/000166624

Cited by 22 publications

(9 citation statements)

References 8 publications

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“…Many previous reports have observed a moderate miscarriage rate, a high rate of prematurity, a high rate of IUGR, a high rate of low birth weight and a high perinatal mortality rate (European Dialysis and Transplant Association 1980; Penn & Makowski 1980; Fine 1982; Davison 1987). Our results agree with these observations.…”

Section: Discussionmentioning

confidence: 96%

“…In our detailed questionnaire group, the presence of an elevated creatinine level before pregnancy, the existence of hypertension during pregnancy, the use of cyclosporin for immunosuppression and episodes of graft rejection during the year before pregnancy were the factors associated with a significantly higher rate of occurrence of adverse fetal or maternal outcome (Table 1). There is general agreement (Rudolph et al 1979; European Dialysis and Transplant Association 1980; Penn & Makowski 1980; Fine 1982; Davison 1987) that an elevated creatinine level before pregnancy is associated with poorer perinatal and maternal outcome. In our series the women with elevated creatinine levels before pregnancy had a significantly higher miscarriage rate and, although not statistically significant, a tendency to a poorer fetal and maternal outcome.…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy after renal transplantation: 25 years experience in Spain

Cararach¹,

Carmona²,

Monleón³

et al. 1993

BJOG

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Objective To study the outcome of pregnancy in renal transplant patients in Spain. Design A retrospective review based on two consecutive national inquiries. Setting Departments of Obstetrics and Gynaecology and Renal Transplant Units in Spain. Subjects Pregnant women who had renal transplants between 1965 and 1989. Main outcome measures From the preliminary inquiry the frequencies of miscarriage, therapeutic abortion, preterm birth, fetal malformation, twins, stillbirths, neonatal deaths and loss of maternal renal function were recorded. The subsequent, more detailed inquiry provided additional information including donor type, previous rejection episodes and interval between rejection and pregnancy, previous creatinine level, previous hypertension and development of hypertension in pregnancy, developments during labour and delivery and the occurrence of intra uterine growth retardation and low birth weight. Results The preliminary inquiry yielded information about 133 pregnancies. The miscarriage rate was 10% and the therapeutic abortion rate was 16%. Of the 99 pregnancies that continued, 46% ended before term and 53% progressed to term. The perinatal mortality rate was 107.8 per 1000 and 4% of the infants had minor congenital malformations. The second inquiry yielded more detailed data about 66 pregnancies. There were no therapeutic abortions and 12% of the pregnancies ended in miscarriage. Among the 58 pregnancies that reached 28 weeks gestation, preterm birth occurred in 28 (48%) and intra uterine growth retardation occurred in 17 (29%). Among 48 women with normal renal function before pregnancy, the perinatal mortality rate was 68 per 1000, the miscarriage rate was 8% and in 10 of these women (21%) renal function was impaired after pregnancy. In constrast, among 18 women with impaired renal function before pregnancy, the perinatal mortality rate was 142 per 1000, the miscarriage rate was 22% and in six of these women (33%) renal function deteriorated after the pregnancy. Impairment of renal function was most common in women with hypertension during pregnancy or with rejection episodes during the year before conception. Conclusions Women with a renal transplant can have a successfull pregnancy, but there are definite risks for both mother and fetus. Pregnancy should be discussed with the woman and encouraged only if there is good renal graft function.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Pregnancy after renal transplantation: 25 years experience in Spain

Cararach¹,

Carmona²,

Monleón³

et al. 1993

BJOG

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“…There does appear to be an increased risk of premature delivery in renal transplant patients, which may be the result of pregnancy-induced hypertension, worsening renal function, or fetal distress [ 127 ] . The commonly used immunosuppressive drugs, such as prednisone, azathioprine, and cyclosporine A, present potential teratogenic risks [ 131,132 ] . However, fetal malformation caused by immunosuppressive drugs appears to be rare and does not contraindicate maintenance of maternal immunosuppression.…”

Section: Resultsmentioning

confidence: 99%

Management of Urological Problems During Pregnancy: A Rationale and Strategy

Loughlin

2012

Essential Urology

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“…The abortion rate is related to the renal function [6]. An increase of acute reversible rejection after delivery has been noted [4,5,8).…”

Section: Discussionmentioning

confidence: 98%

Pregnancy in kidney recipients under cyclosporine

Berardinelli¹,

Dallatana²,

Beretta³

et al. 1992

Transplant International

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About 1 of every 50 women of child-bearing age who have a functioning kidney transplant become pregnant. Successful pregnancies following kidney allotransplantation with conventional immunosuppressive treatment are well described [8), and there is no evidence of abnormalities in the infants born. The use of cyclosporine (CSA) means new problems for the pregnant women and the fetus: the risk of congenital abnormalities, fetal growth retardation, hepato-and nephrotoxicity.We report the experience of 16 pregnancies in 16 of our kidney transplant patients, of which 7 were treated with CSA.

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Pregnancy in Renal Allograft Recipients

Cited by 22 publications

References 8 publications

Pregnancy after renal transplantation: 25 years experience in Spain

Pregnancy after renal transplantation: 25 years experience in Spain

Management of Urological Problems During Pregnancy: A Rationale and Strategy

Pregnancy in kidney recipients under cyclosporine

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