A report of three consecutive pregnancies in a kidney transplant recipient and the challenges in their management in a poor resource setting.
Kidney transplant recipients (KTR) have a good outcome of pregnancies. However the mother and the child are increasingly at higher risks of complications compared to the general population. The management of these pregnancies is associated with greater challenges and is better if managed by both the obstetrician and the transplant physician. Kidney transplant is available in few centres in Nigeria and the post transplant population is increasing, but to our knowledge no report on pregnancy management in KTR has been published. We present a 25 years old Nigerian who had a live related kidney transplant and later had 3 consecutive pregnancies and review the relevant literature. She was placed on oral contraceptive pills for 2 years after transplantation. She enjoyed a stable allograft function with no rejection episode, no proteinuria, had a good blood pressure control and pelvic ultrasound scan was essentially normal. She conceived her first pregnancy 26 months post transplant however she developed spontaneous abortion at 3 months gestation. She conceived her second pregnancy 33 months post transplant which was supervised by the obstetrician and the transplant physician. She had complications including urinary tract infection, anaemia and dyslipidaemia and delivered a live baby girl weighing 2.4 Kg by spontaneous vaginal delivery at 36 weeks gestation. She conceived her 3rd pregnancy 8 months later which was also carried to term and had a vaginal delivery of a live baby girl weighing 2.55 kg. This report highlights the successful management of pregnancies in KTR and the challenges faced in a poor resource setting.
Department of Medicine, Aminu Kano Teaching Hospital/Bayero University Kano, Nigeria. aliyuabdu2000@yahoo.co.uk
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Abdu
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Galadanci
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Adamu
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Nalado
D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D016030:Kidney Transplantation / Q000502:physiology; D009549:Nigeria; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk
D007166:Immunosuppressive Agents