Obstetric Outcomes in Kidney Transplant Recipients
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0611
- VernacularTitle:妊娠合并肾移植术后的妊娠结局分析
- Author:
Cai-xia ZHU
1
;
Ma-lie WANG
1
;
Juan YANG
1
;
Lin-jing YUAN
1
;
Gang NIU
1
Author Information
1. Department of Obstetrics and Gynecology， The First Affiliated Hospital， Sun Yat-sen University， Guangzhou 510080， China
- Publication Type:Journal Article
- Keywords:
kidney transplantation;
pregnancy;
obstetric outcome;
pregnancy complication
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(6):900-905
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the obstetric outcomes of pregnancies in women with kidney transplant. MethodsA retrospective study was done on 12 kidney transplant recipients who gave birth in the First Affiliated Hospital， Sun Yat-sen University between January 2015 and May 2021. The clinical data and obstetric outcomes were analyzed. ResultsAmong 12 kidney transplant recipients， 3 had full-term births and 9 preterm births. The mean maternal age was （32.3±4.5） years， with a mean period of （63.3±34.7） months after kidney transplantation. The mean gestation at birth was （34.8±2.3） weeks. All the recipients received tacrolimus， predinisone and azathioprine for immunosuppression during pregnancy， with effective range of tacrolimus blood concentration. Of 12 recipients， 6 switched from use of mycophenolate mofetil before pregnancy to Azathioprine in the first trimester. There were 7 cases of preeclampsia in the third trimester， 3 gestational diabetes mellitus， 4 moderate anemia， 2 mild anemia and 1 central placenta previa. Eleven cases had cesarean sections and one had vaginal spontaneous delivery. No case suffered postpartum hemorrhage and puerperal infection. Two cases developed renal graft dysfunction requiring hemodialysis 42 days after delivery. All the 12 live births were singleton and the mean birth weight was （2 348±698.8） g， with 7 with low birth wight and 8 transferred to neonatal intensive care unit （NICU）. All the newborns showed no birth defect and their average length of hospital stay was 14 days. They were artificially fed and no abnormality was found in their physical development， intelligence and immune system during follow-up. ConclusionDue to the high risk of pregnancy after kidney transplantation， multidisciplinary collaborative and individualized precise diagnosis and treatment are encouraged. The optimal pregnancy timing， close maternal/fetal monitoring and timely pregnancy termination could improve the obstetric outcomes in kidney transplant recipients.
