Case report of a successful term pregnancy following renal transplantation

Prabhadevi Kodey; Badugu Rao Bahadur; V. Srilatha; G. Srinivasa Rao; Sowjanya P.

doi:10.18203/2320-1770.ijrcog20193581

Authors

Prabhadevi Kodey Department of Obstetrics and Gynaecology, NRI Medical College, Mangalagiri, Guntur, Andhra Pradesh, India
Badugu Rao Bahadur Department of Obstetrics and Gynaecology, NRI Medical College, Mangalagiri, Guntur, Andhra Pradesh, India
V. Srilatha Department of Nephrology, NRI Medical College, Mangalagiri, Guntur, Andhra Pradesh, India
G. Srinivasa Rao Department of Urology, NRI Medical College, Mangalagiri, Guntur, Andhra Pradesh, India
Sowjanya P. Department of Obstetrics and Gynaecology, NRI Medical College, Mangalagiri, Guntur, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20193581

Keywords:

Creatinine, Immunosuppressive therapy, Pregnancy, Renal transplant

Abstract

Pregnancy with renal disease is associated with high risk for both mother and fetus with adverse outcomes. Criteria for considering pregnancy in renal transplanted patients include good post-transplant health for 2 years, stable allograft function with a serum creatinine <1.5 mg/dl, absence of rejection, control of blood pressure, absence of proteinuria. Authors report a case of 26-year-old, primigravida had renal transplantation done in NRI Medical College and treated with immunosuppressive therapy with tablets Tacrolimus 1mg twice daily, Azathioprine 50mg twice daily, Prednisolone 10mg once daily and continued till delivery. Developed gestational hypertension treated with tablet Amlodipine 5mg once daily. Elective caesarean section done for contracted pelvis. Post-natal period was uneventful and discharged on immunosuppressive therapy and contraceptive advice. Post-renal transplantation pregnancy should have multidisciplinary approach for. With close medical and obstetric follow up, successful outcome for both mother and infant is possible.

Metrics

Metrics Loading ...

Author Biography

Sowjanya P., Department of Obstetrics and Gynaecology, NRI Medical College, Mangalagiri, Guntur, Andhra Pradesh, India

References

Fuchs KM, Coustan DR. Immunosuppressant therapy in pregnant organ transplant recipients. Semin Perinatol. 2007 Dec 1:31(6):363-71.

Ostensen M, Khamashta M, Lockshin M, Parke A, Brucato A, Carp H, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006:8(3):209.

Guazzelli CA, Torloni MR, Sanches TF, Barbieri M, Pestana JO. Contraceptive counseling and use among 197 female kidney transplant recipients. Transplantation. 2008 Sep 15;86(5):669-72.

McKay DB, Josephson MA. Reproduction and transplantation: report on the AST Consensus conference on reproductive issues and transplantation. Am J Transplantation. 2005 Jul;5(7):1592-9.

Zerner J, Doil KL, Drewry J, Leeber DA: Intrauterine contraceptive device failures in renal transplant patients. J Reprod Med. 1981 Feb ;26(2):99-102.

Lessan-Pezeshki M, Ghazizadeh S, Khatami MR, Mahdavi M, Razeghi E, Seifi S, et al: Fertility and contraceptive issues after kidney transplantation in women. Transplant Proc. 2004 Jun 1;36(5):1405-6.

Davison JM, Bailey DJ: Pregnancy following renal transplantation. J Obstet Gynaecol Res. 2003;29:227 -33.

Mastrobattista JM, Katz AR: Pregnancy after organ transplant. Obstet Gynecol Clin North Am. 2004;31 :415-28.

Josephson MA, McKay DB: Considerations in the medical management of pregnancy in transplant recipients. Adv Chronic Kidney Dis. 2007 Apr 1;14(4):156-67.

EBPG expert group in renal transplantation: European best practice guidelines for renal transplantation. Section IV: Longterm management of the transplant recipient. IV. 10. Pregnancy in renal transplant recipients. Nephrol Dial Transplant. 2002;17(4):50-5.

Stratta P, Canavese C, Giacchino F, Mesiano P, Quaglia M, Rossetti M. Pregnancy in kidney transplantation: satisfactory outcomes and harsh realities. J Nephrol. 2003;16(6):792-806.

Sibanda N, Briggs JD, Davison JM, Johnson RJ, Rudge CJ: Pregnancy after organ transplantation: A report from the UK Transplant pregnancy registry. Transplantation. 2007 May 27;83(10):1301-7.

Armenti VT, Moritz MJ, Davison JM: Pregnancy in female pediatric solid organ transplant recipients. Pediatr Clin North Am. 2003 Dec;50(6):1543-60.

Armenti VT, Moritz MJ, Cardonick EH, Davison JM: Immunosuppression in pregnancy: Choices for infant and maternal health. Drugs. 2002 Nov 1;62(16):2361-75.

Umans JG: Medications during pregnancy: Antihypertensives and immunosuppressives. Adv Chronic Kidney Dis. 2007 Apr 1;14(2):191-8.

Podymow T, August P: Hypertension in pregnancy. Adv Chronic Kidney Dis. 2007 Apr 1;14(2):178-90.

Yassaee F, Moshiri F: Pregnancy outcome in kidney transplant patients. Urol J. 2007;4(1):14-7.

Oliveira LG, Sass N, Sato JL, Ozaki KS, Medina Pestana JO: Pregnancy after renal transplantation: A fiveyr singlecenter experience. Clin Transplant. 2007 May;21(3):301-4.

McKay DB, Josephson MA: Pregnancy in recipients of solid organs: Effects on mother and child. N Engl J Med. 2006 Mar 23;354(12):1281-93.

Cruz Lemini MC, Ibargüengoitia OF, Villanueva GMA. Perinatal outcome following renal transplantation. Int J Gynecol Obs. 2007;96(2):76-9.

Del Mar Colon M, Hibbard JU: Obstetric considerations in the management of pregnancy in kidney transplant recipients. Adv Chronic Kidney Dis. 2007 Apr 1;14(2):168-77.