[Pregnancy after kidney transplantation].
The course of 13 pregnancies in 12 women (mean age 28 [19-34] years) after renal transplantation was analysed retrospectively. The average period from renal transplantation to the beginning of pregnancy was 45 [7-144] months. All patients received methylprednisolone for immunosuppression, while seven each additionally received azathioprine and/or cyclosporin. At the onset of pregnancy the transplant function was good or only slightly impaired in 11 women (serum creatinine 1.3 [0.8-1.8] mg/dl). But in one patient, a diabetic with nephrotic syndrome, serum creatinine concentration was raised to 2.4 mg/dl. In six patients the cyclosporin dosage had to be increased during the pregnancy. Severe complications were: acute rejection in the 16th week of pregnancy; acute renal failure during a recurrence of haemolytic-uraemic syndrome in the 36th week; and severe renal anaemia (haemoglobin 6.7 g/dl). An irreversible rise in creatinine concentration occurred in five women and hypertension got worse in eight. The mean duration of pregnancy was 35.5 (32-38) weeks. The average birth weight was low (1892 g [970-2560 g]): five children were dystrophic. The dystrophy rate was the same under cyclosporin as under the conventional immunosuppressants. The findings indicate that pregnancy after renal transplantation presents a high risk for mother and child. It demands intensive joint care by obstetrician, paediatrician and nephrologist.
Abteilung für Nephrologie, Universität Düsseldorf.
H
H
Röwemeier
F W
FW
Kemmer
T
T
Somville
B
B
Grabensee
D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D005317:Fetal Growth Retardation; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods / Q000706:statistics & numerical data; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D016030:Kidney Transplantation / Q000502:physiology* / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000453:epidemiology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D003404:Creatinine
Schwangerschaft nach Nierentransplantation.