期刊
JOURNAL OF PERINATAL MEDICINE
卷 50, 期 2, 页码 185-191出版社
WALTER DE GRUYTER GMBH
DOI: 10.1515/jpm-2021-0102
关键词
graft dysfunction; kidney transplant; preeclampsia; pregnancy
Pregnant kidney transplant recipients are at high risk of complications and require multidisciplinary follow-up. This study found a significant correlation between pre-pregnancy graft function and adverse outcomes, particularly with increased proteinuria and creatinine levels. In patients with these risk factors, stricter monitoring is needed to promptly detect complications.
Objectives Maternal and fetal complications can occur in pregnant kidney transplant recipients. Since these are high-risk pregnancies, they require a multidisciplinary follow-up to prematurely detect adverse events. Identifying factors that would affect fetal, maternal and graft outcomes is essential to further stratify the risk of pregnant kidney transplant recipients. Methods All pregnancies in kidney transplant recipients followed in a single center for 30 years were included. Data included previous transplant information and blood and urine tests performed before pregnancy. Impact of graft function on fetal, maternal and graft outcomes was evaluated. Results There were 41 pregnancies among 34 patients. Mean gestational age of 35 +/- 3 weeks. Caesarean section was performed in 69.4% of patients. Five pregnancies were unsuccessful (12.2%). Four patients suffered an acute graft dysfunction (9.8%) and 12 (29.3%) had a serious maternal hypertensive disorder (preeclampsia, eclampsia or HELLP syndrome). Graft function before pregnancy showed significant correlation with adverse outcomes. Conclusions A proteinuria >669 mg/g, serum creatinine >1.75 mg/dL and glomerular filtration rate <36.2 mL/min/1.73 m(2) before pregnancy were correlated to graft dysfunction during pregnancy. Similar values of proteinuria were also associated with a risk of maternal hypertensive disorders and pregnancy failure. Therefore, in patients with proteinuria and graft dysfunction, follow-up should be stricter to quickly detect complications.
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