Pregnancy management of diabetic renal transplant patients

Advances in medical care and options for medications for diabetic kidney transplant recipients have allowed for successful pregnancies to be carried to full term. End-stage renal disease leads to impaired fertility. Fertility is restored 1 to 6 months after a successful kidney transplant. Poor glycemic control near the conception period leads to a higher incidence of major fetal malformations and spontaneous abortion. Preconception counseling about risks of medications, control of comorbid conditions, stability of allograft function, and potential risks to mother, fetus, and allograft has to be done. Close and careful monitoring of mother, fetus, and allograft is important in ensuring a good outcome.