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[Pregnancy after kidney transplantation]

H Röwemeier1, F W Kemmer, T Somville

  • 1Abteilung für Nephrologie, Universität Düsseldorf.

Deutsche Medizinische Wochenschrift (1946)
|May 7, 1993
PubMed
Summary

Pregnancy after kidney transplantation is high-risk for mothers and infants. Close collaboration between obstetricians, pediatricians, and nephrologists is crucial for managing these complex pregnancies.

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Area of Science:

  • Nephrology
  • Obstetrics
  • Immunology

Background:

  • Retrospective analysis of 13 pregnancies in 12 women post-renal transplantation.
  • Average time from transplantation to pregnancy: 45 months.
  • Immunosuppression primarily methylprednisolone, with azathioprine and/or cyclosporine in seven patients.

Observation:

  • 11 women had good or slightly impaired transplant function at pregnancy onset.
  • One diabetic patient with nephrotic syndrome had elevated creatinine (2.4 mg/dl).
  • Six patients required increased cyclosporine dosage during pregnancy.

Findings:

  • Severe complications included acute rejection, renal failure from hemolytic-uremic syndrome recurrence, and severe anemia.
  • Five women experienced irreversible creatinine rise; eight had worsening hypertension.
  • Mean pregnancy duration was 35.5 weeks; average birth weight was low (1892g), with five dystrophic infants.

Implications:

  • Pregnancy post-renal transplant poses significant risks to both mother and child.
  • Requires multidisciplinary care involving obstetricians, pediatricians, and nephrologists.
  • Cyclosporine use showed similar dystrophy rates compared to conventional immunosuppressants.

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