title: Pregnancy outcomes among female recipients after liver transplantation: further experience.
abstract: BACKGROUND
  Liver transplantations give female recipients an ability to carry pregnancies successfully. However, solid organ transplantations exacerbate the pregnancy including maternal and neonatal outcomes. The aim of our study was to evaluate and identify the obstetric outcomes in women with a prior liver transplantation.
  
  
  METHODS
  We analyzed all pregnant woman who had undergone a prior liver transplantation and afterward delivered from 2001 to 2011. Complete data were assessed in 39 deliveries and 40 live births. Three women were pregnant twice after liver transplantation.
  
  
  RESULTS
  The mean gestational age at birth measured 37.2±2.2 weeks. The most common obstetric complications were premature labor (12/39,30.8%), hypertension (10/39, 25.6%), and symptomatic urinary tract infections (7/39, 18%). Other complications were pregestational diabetes (n=1), cholestasis (n=3), and of severe anemia treated with blood transfusions (n=2). The mean time from organ transplantation to delivery was 67.6±47.2 months. Acute graft rejections occurred among pregnant women 7.7% (3/39) of studied. Only 8 (20.5%) deliveries were finished vaginally. Infants small for gestational age were diagnosed in 20% (8/40). One case displayed a congenital urinary tract malformation. None of the neonates died neonatally.
  
  
  CONCLUSIONS
  Pregnancies are possible after liver transplantation and likely end with successful maternal and newborn outcomes. Some cases experience an increased risk of obstetric complications. Therefore, posttransplant pregnancies must be regularly monitored with a multidisciplinary approach.
authors: 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland. zoulika@tlen.pl
authors: Z
authors: Z
authors: Jabiry-Zieniewicz
authors: M
authors: M
authors: Szpotanska-Sikorska
authors: B
authors: B
authors: Pietrzak
authors: B
authors: B
authors: Kociszewska-Najman
authors: B
authors: B
authors: Foroncewicz
authors: K
authors: K
authors: Mucha
authors: K
authors: K
authors: Zieniewicz
authors: M
authors: M
authors: Krawczyk
authors: M
authors: M
authors: Wielgos
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016031:Liver Transplantation / Q000009:adverse effects*; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology; D011251:Pregnancy Complications, Infectious / Q000209:etiology; D011256:Pregnancy Outcome; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000209:etiology; D055815:Young Adult