[Pregnancy after heart and heart-lung transplantation. Apropos of 10 cases and review of the literature].

INTRODUCTION

A survey of all French Centres performing heart and heart lung transplant provided an exhaustive registry of pregnancy after transplantation.

MATERIAL AND METHODS

A questionnaire was sent to 36 Centres. Anonymous reports of transplantation and subsequent pregnancies which occurred between 1984 and 1994 were analyzed.

RESULTS

Among 1290 heart and 120 heart lung transplantations performed during the study period 10 pregnancies were reported in 9 patients (6 after heart transplantation and 3 heart-lung transplantation) who gave birth to 11 neonates. The interval between the transplantation and the pregnancy is 23.1 months (range: 10-39). High blood pressure complicated nine pregnancies and severe preeclampsia occurred in two cases. Immunosuppressive therapy was i) Cyclosporine alone (n = 1), ii) i with corticosteroid therapy (n = 7), iii) ii with azathioprine (n = 2). One patient developed Kaposi sarcoma of the cervix. Delivery at 35 (27-39) weeks' gestation was by caesarean section in 50% of the cases. Mean birthweight was 1990 gm (range: 700-2880) and 50% of the neonates were below the tenth centile. One child developed cardiomyopathy as diagnosed in her mother and another one was diagnosed with congenital hepatitis B by absence of prophylaxis at birth. All the patients are alive at this time.