Golocan-Alquiza Ian Feb G, Cabanayan-Casasola Concesa B, Faustino Karen M, Flores Ma Estrella
Department of Adult Nephrology, National Kidney and Transplant Institute, Quezon City, Philippines.
Department of Adult Nephrology, National Kidney and Transplant Institute, Quezon City, Philippines.
Transplant Proc. 2019 Oct;51(8):2718-2723. doi: 10.1016/j.transproceed.2019.02.058. Epub 2019 Aug 30.
Kidney transplantation (KT) has been shown to improve fertility rates among women post-transplant. However, despite the favorable outcome, the impact of pregnancy on the graft and the graft's effect on the fetus should be considered. In addition, these patients are exposed to anti-rejection medications that could affect the fetus.
To describe the graft and pregnancy outcomes among KT recipients.
Descriptive study of 32 post-KT recipients who were pregnant from January 1, 2001 to December 31, 2016 and were followed up 3 months post-partum. Each pregnancy was considered as an event.
Among the 32 post-KT patients there were 38 pregnancies. Mean age at conception was 34 years, with a mean interval between KT and pregnancy of 4.8 years. Around 84% took cyclosporine-based immunosuppression. The mean pre-natal serum creatinine was 1.15 mg/dL, 5.3% had ≥ 1.5 mg/dL pre-natal creatinine, and the rejection rate was 10.5%. The results of the pregnancies were as follows: 94% resulted in live births, 18.42% of mothers had pre-eclampsia, 3% had eclampsia, 3% ended in abortion, and 3% were stillbirth. Sixty-eight percent of the pregnancies were unplanned, and more complications were observed among these patients.
The maternal and fetal outcomes and complications in this study were comparable with other studies. However, most of these complications were observed with unplanned pregnancies. Counselling prior to pregnancy should therefore be emphasized.
肾移植（KT）已被证明可提高移植后女性的生育率。然而，尽管有良好的结果，但仍应考虑妊娠对移植物的影响以及移植物对胎儿的影响。此外，这些患者会接触到可能影响胎儿的抗排斥药物。
描述肾移植受者的移植物和妊娠结局。
对2001年1月1日至2016年12月31日期间怀孕且产后3个月接受随访的32例肾移植受者进行描述性研究。每次妊娠被视为一个事件。
32例肾移植患者中有38次妊娠。受孕时的平均年龄为34岁，肾移植与妊娠之间的平均间隔为4.8年。约84%的患者采用基于环孢素的免疫抑制治疗。产前血清肌酐的平均值为1.15mg/dL，5.3%的患者产前肌酐≥1.5mg/dL，排斥率为10.5%。妊娠结果如下：94%为活产，18.42%的母亲患有先兆子痫，3%患有子痫，3%以流产告终，3%为死产。68%的妊娠为意外妊娠，这些患者中观察到更多并发症。
本研究中的母婴结局和并发症与其他研究相当。然而，这些并发症大多发生在意外妊娠中。因此，应强调妊娠前的咨询。
