Christensen C
Ugeskr Laeger. 1991 Sep 2;153(36):2468-74.
Renal transplantation is invariably accompanied by improvement in reproductive function. The possibility of conception in women of childbearing age emphasises the need for sensible counselling. Most authorities advise a delay of about two years post-transplantation. This appears to be good advice, because by then the patient will have recovered from the major surgical sequelae, renal function will have become stabilized with a very high probability of allograft survival at five years and immunosuppression will also be at a maintenance level. Renal function should be stable with a S-creatinine less than 130 micromoles/l. About 40% of all conceptions do not proceed beyond the first trimester. The overall complication rate in pregnancy continuing beyond the first trimester is 46%. If complications, usually uncontrolled hypertension, renal deterioration or rejection, occur before 28 weeks of gestation then successful obstetric outcome occurs in 73% compared to 92% when pregnancy is trouble-free before 28 weeks. Remote problems occur in 11% of women after delivery but where the pregnancy is complicated prior to 28 weeks remote problems occur in 24%. It is of course, difficult to know whether problems are precipitated by pregnancy or are time-dependent and would have occurred in any case.
肾移植总是伴随着生殖功能的改善。育龄女性怀孕的可能性凸显了进行合理咨询的必要性。大多数权威机构建议在肾移植后推迟约两年。这似乎是个好建议，因为到那时患者将已从重大手术后遗症中恢复，肾功能很可能已稳定，移植肾在五年内存活的概率很高，免疫抑制也将处于维持水平。肾功能应稳定，血清肌酐低于130微摩尔/升。所有妊娠中约40%无法超过孕早期。孕早期后继续妊娠的总体并发症发生率为46%。如果在妊娠28周前出现并发症，通常是难以控制的高血压、肾功能恶化或排斥反应，那么成功的产科结局发生率为73%，而妊娠在28周前无问题时这一比例为92%。产后11%的女性会出现远期问题，但如果妊娠在28周前出现并发症，远期问题的发生率为24%。当然，很难知道问题是由妊娠引发的，还是与时间有关且无论如何都会出现。
