Kashif Waqar, Yaqub Sonia, Ahmed Hina, Khan Nauman, Subhan Amna, Hussain Syed Ather
Section of Nephrology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
Iran J Kidney Dis. 2013 Sep;7(5):407-11.
Overall success rate of pregnancies in kidney transplant recipients is higher than 90% if pregnancy goes beyond the 1st trimester. Risks to mother include hypertension, preeclampsia, infections, and worsening proteinuria, and those to the fetus are prematurity, intrauterine growth retardation, and low birth weight. Hepatitis B infection is associated with progressive liver disease and diminished survival in kidney transplant recipients. A 32-year-old woman had undergone living unrelated donor kidney transplant. Two years after transplantation, she presented with live gestation of 6 weeks. She was also found positive for hepatitis B surface antigen and extracellular antigen. Liver enzymes were normal and ultrasonography findings were normal. Cyclosporine dose was reduced and lamivudine was started. She was monitored closely until 33 weeks, when she gave birth to a healthy female baby through spontaneous vaginal delivery. The newborn received vaccination and immunoglobulins for hepatitis B virus. Mother's kidney allograft function remained stable throughout pregnancy.
如果妊娠超过孕早期，肾移植受者的总体妊娠成功率高于90%。母亲面临的风险包括高血压、先兆子痫、感染和蛋白尿加重，而胎儿面临的风险是早产、宫内生长受限和低出生体重。乙型肝炎感染与肾移植受者的进行性肝病和生存率降低有关。一名32岁女性接受了非亲属活体供肾移植。移植两年后，她出现了6周的活胎妊娠。她的乙型肝炎表面抗原和细胞外抗原检测也呈阳性。肝功能酶正常，超声检查结果正常。环孢素剂量减少，并开始使用拉米夫定。对她进行密切监测直至33周，此时她通过自然阴道分娩产下一名健康女婴。新生儿接种了乙肝疫苗并注射了乙肝免疫球蛋白。母亲的肾移植功能在整个孕期保持稳定。
