[Pregnancy in recipients of kidney transplantation: effects on mother and child].
When the field of transplantation was first developing, physicians worried about the teratogenicity of immunosuppressive medications and considered pregnancy ill-advised. The purpose of this study is to analyze pregnancy after kidney transplantation and their consequences on mother, graft and child. We review ten pregnant women with kidney transplantation, average of 29 years old and 44 months post-kidney transplantation. The mean glomerular filtration rate was 64 ml/min and the immunosuppression was with prednisone and tacrolimus. We analyze outcomes of different variables before and during pregnancy, and after labour. Pregnancy finished in nine of ten patients. Three patients needed cesarean section and only one patient had a miscarriage on the first term. Blood arterial pressure increased at the end of pregnancy and the creatinine level was stable with a few increase of proteinuria at the third term. We increased the tacrolimus dose to obtain the correct blood levels and any rejection was detected. We had only one patient with preeclampsia that we solved with a cesarean section. Labours were a mean of 37.2 weeks and the mean birth weight of infant was 2,809 grams. Two newborns had prematurity without structural malformations. Pregnancy after kidney transplantation is safe with prednisone and tacrolimus when the renal function is good, proteinuria doesn't exist and blood pressure is controlled.
Díaz
J M
JM
Servicio de Nefrología, Fundación Puigvert, Barcelona. jdiaz@fundacio-puigvert.es
Canal
C
C
Giménez
I
I
Guirado
L
L
Facundo
C
C
Solà
R
R
Ballarín
J
J
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016030:Kidney Transplantation; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies