Yassaee Fakhrolmolouk, Moshiri Farnaz
Department of Obstetrics and Gynecology, Perinatology Center, Taleghani Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Urol J. 2007 Winter;4(1):14-7.
Advances in surgical techniques and immunosuppressive therapy have improved the survival and quality of life in organ transplant patients. Thus, the number of organ transplant women at their reproductive age has also increased. We sought to investigate the allograft and obstetric outcomes in pregnant kidney recipients.
Seventy-four kidney recipient women with 95 conceptions during their posttransplant period were evaluated. Pregnancy outcome, kidney allograft function, and maternal, fetal, and neonatal complications were evaluated in these patients.
The mean interval between kidney transplantation and pregnancy was 41.0 +/- 9.5 months. Twenty-three pregnancies (24.2%) were unsuccessful due to abortion and stillbirth. The mean birth weight was 2385.0 +/- 161.7 g and 45 newborns (62.5%) had a birth weight less than 2500 g (low birth weight). The mean Apgar score of the live babies was 7.9 +/- 0.7. Forty-four (61.1%) babies were admitted to neonatal intensive care unit and early neonatal death happened in 4 (5.5%). Fifteen mothers (15.78%) had an uneventful perinatal period. The most common maternal complications in the 95 pregnancies were anemia in 62 (65.3%) and preeclampsia in 45 (47.4%). Three patients 3 (3.2%) lost their graft and 6 (6.3%) had impaired kidney allograft function 2 years after pregnancy.
Pregnant kidney allograft recipients should be considered as high-risk patients needing special care under the supervision of a team of obstetricians and nephrologists.
手术技术和免疫抑制疗法的进步提高了器官移植患者的生存率和生活质量。因此，处于生育年龄的器官移植女性数量也有所增加。我们旨在研究妊娠肾移植受者的移植肾及产科结局。
对74例肾移植受者女性在移植后期间的95次妊娠情况进行了评估。评估了这些患者的妊娠结局、移植肾功能以及母体、胎儿和新生儿并发症。
肾移植与妊娠之间的平均间隔时间为41.0±9.5个月。23次妊娠（24.2%）因流产和死产而失败。平均出生体重为2385.0±161.7克，45例新生儿（62.5%）出生体重低于2500克（低出生体重）。存活婴儿的平均阿氏评分是7.9±0.7。44例（61.1%）婴儿入住新生儿重症监护病房，4例（5.5%）发生早期新生儿死亡。15名母亲（15.78%）围产期情况平稳。95次妊娠中最常见的母体并发症是62例（65.3%）贫血和45例（47.4%）先兆子痫。3例患者（3.2%）在妊娠2年后移植肾失功，6例（6.3%）移植肾功能受损。
妊娠肾移植受者应被视为高危患者，需要在产科医生和肾病学家团队的监督下接受特殊护理。
