title: Successful multiple pregnancy (triplets) in a kidney transplant recipient: a case report.
abstract: Renal failure generally accompanies an alteration in reproduction function. Even though a renal transplantation does in fact improve this function, there are few cases described in medical literature of multiple pregnancies in transplant patients that ended in a successful manner. In addition, there is a greater incidence of complications such as hypertension, preeclampsia, and premature delivery. This article describes a 31-year-old patient who became pregnant with triplets at 3 years and 6 months after receiving a renal transplant from a cadaver. The patient received treatment with cyclosporine, azathioprine, and prednisolone. During the pregnancy, there was a increase in hypertension, proteinuria, cholestasia gravidic symptoms, and premature delivery. Pregnancy control included evaluation of the fetoplacental unit together with hypertensive management and adjustment of immunosuppressant treatment, especially the cyclosporine dose, seeking to facilitate greater fetal maturity. Three newborns of 840, 860, and 1020 were delivered by cesarean section. The newborns spent 6 to 8 weeks in the neonatal unit and were released without complications. The newborns have presented adequate psychomotor and physical development to date. The triplets are now 4 years old. The transplant recipient has a creatinine clearance of 81 mL/min at 7 years after transplantation.
authors.affiliation: Renal Unit, Department of Internal Medicine, Carlos Van Buren Hospital, Valparaíso University, Valparaíso, Chile. vnicovani@vtr.net
authors.forename: V
authors.initials: V
authors.lastname: Nicovani
authors.forename: H
authors.initials: H
authors.lastname: Poblete
authors.forename: J
authors.initials: J
authors.lastname: Toro
authors.forename: M
authors.initials: M
authors.lastname: Carrera
authors.forename: L
authors.initials: L
authors.lastname: Pérez
mesh_terms: D000328:Adult; D002102:Cadaver; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging; D016030:Kidney Transplantation / Q000276:immunology*; D009543:Nifedipine / Q000627:therapeutic use; D010062:Ovulation Induction; D011183:Postoperative Complications / Q000188:drug therapy; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000502:physiology*; D014019:Tissue Donors; D014310:Triplets; D014463:Ultrasonography
chemical_list: D007166:Immunosuppressive Agents; D009543:Nifedipine