Ben Haj Hassine Amine, Siala Haythem, Basly Mohamed, Harzallah Kais, Chibani Mounir, Rachdi Radhouane
Tunis Med. 2014 Aug-Sep;92(8-9):523-6.
Motherhood has long been not recommended for kidney transplanted women for fear of adverse effects on the graft and the risks to the fetus.
This article aimed to provide evidence based answer to the following questions regarding pregnancy in kidney transplanted women: 1. what are the nephrologic and obstetrical parameters that can influence the pregnancy outcome? 2. What is the impact of pregnancy on graft? 3. What are the optimal conditions for pregnancy planning in kidney transplanted women?
A literature search was conducted using as key words "pregnancy", "renal transplant", "renal graft survival" in the PubMed database over the period from January 1994 to December 2011.
Recovery of renal function in kidney transplanted patients is followed by restoration of endocrine function. Knowledge of the initial nephropathy assesses the risk of recurrence after transplantation, which may affect the graft. Chronic glomerular nephropathies are the most frequent from 32 to 76.1%. Duration of hemodialysis (over 2 years) is associated with a risk of preterm delivery and growth retardation. A period of 1 year between renal transplantation and conception seems reasonable to stabilize renal function and reduce the doses of immunosuppressants. The number of unintended pregnancies remains high (50%). The incidence of pregnancy after renal transplantation varies between 3 and 21.2%. Graft survival in patients who carried a pregnancy is equivalent to that of patients who were not pregnant.
Pregnancy in kidney transplanted patients is a highrisk pregnancy, but it does not seem to affect graft function through certain conditions.
长期以来，肾移植女性一直不被建议生育，因为担心对移植物产生不良影响以及对胎儿构成风险。
本文旨在为肾移植女性妊娠相关的以下问题提供循证答案：1. 哪些肾脏和产科参数会影响妊娠结局？2. 妊娠对移植物有何影响？3. 肾移植女性妊娠计划的最佳条件是什么？
在1994年1月至2011年12月期间，使用关键词“妊娠”“肾移植”“肾移植物存活”在PubMed数据库中进行文献检索。
肾移植患者肾功能恢复后，内分泌功能也会恢复。了解初始肾病可评估移植后复发风险，这可能会影响移植物。慢性肾小球肾病最为常见，占比32%至76.1%。血液透析时间（超过2年）与早产和生长迟缓风险相关。肾移植与受孕之间间隔1年似乎较为合理，可稳定肾功能并减少免疫抑制剂剂量。意外妊娠的比例仍然很高（50%）。肾移植后妊娠发生率在3%至21.2%之间。妊娠患者的移植物存活率与未妊娠患者相当。
肾移植患者妊娠是高危妊娠，但在某些条件下似乎不会影响移植物功能。
