Pregnancy following renal transplantation

From 1968 through 1974 at the University of Minnesota there were 17 pregnancies in 12 patients who were renal transplant recipients. Three were cadaver transplants and nine were transplants from living related donors. In eight patients there were two first-trimester pregnancy termination, three mid-trimester abortions by hysterotomy, and one spontaneous abortion. Two of the induced abortions were in patients with ileal conduits. There were no unusual major obstetric complications but toxemia of pregnancy and concurrent bacterial and viral infections were common medical problems. Of the liveborn infants, only three of the 12 were small for their gestational age, seven were of appropriate size, and two were large. There were no neonatal problems and no congenital anomalies. Renal function during pregnancy was carefully monitored and was compromised in three of the patients studied. One patient had three pregnancies, including the delivery of a set of twins. Several months following her third delivery she developed fatal hepatitis. Two patients developed carcinoma in situ of the cervix. Pregnancy following renal transplantation is not without risk. Sexually active female transplant recipients should be counseled regarding pregnancy and sterilization should be offered as an option at the time of transplantation.