[Pregnancy in patients with renal transplantation: maternal and fetal morbidity].
BACKGROUND
Preeclampsia is a multisystemic syndrome with unknown etiology and characterized by abnormal vascular placentation response. Patients with renal transplantation restore them fertility 10 months after the intervention.


OBJECTIVE
To evaluate incidence of preeclampsia and maternal-perinatal outcome in patients with renal transplantation.


METHODS
Comparative, observational and retrospective study performed in pregnant patients with renal transplantation, from December 1999 to April 2008 at Perinatology of Hypertensive Diseases Department of the Unidad Medica de Alta Especialidad de Ginecoobstetricia Luis Castelazo Ayala, IMSS. Davison' guide, descriptive statistic, and Fischer exact test were used.


RESULTS
Thirty patients were analyzed, 27 cases satisfy Davison's recommended guidelines, and the rest did not achieve these criteria (p = 0.001). Preeclampsia occurred in 15 cases (50%), preterm delivery in 15 (50%), and fetal growth restriction in 6 (20%). Among the 11 patients with previous chronic hypertension, 8 developed superimposed preeclampsia (72%), and 9 had delivery before 37 weeks of gestation (82%). Malfunction of renal transplantation, before pregnancy, was associated with maternal and perinatal poor outcome (p = 0.006). There were no maternal deaths, but one perinatal (3%)


CONCLUSIONS
Successful pregnancy is possible in patients with renal transplantation, however there is a high risk of preeclampsia, infection, and fetal growth restriction. Patients with renal transplantation must fulfill Davison's pre-pregnancy guidelines.
Romero Arauz
Juan Fernando
JF
Servicio de Complicaciones Hipertensivas del Embarazo, Unidad Médica de Alta Especialidad Luís Castelazo Ayala, IMSS. jfromarauz@hotmail.com
Ayala Méndez
José Antonio
JA
Jiménez Solís
Guillermo
G
D000293:Adolescent; D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult