| Abstract [eng] |
Objective. Based on literature sources and anonymized and retrospectively collected data from the Nephrology and transplantation department of VUL SK, pregnancy outcomes of patients who underwent transplantation were analyzed, including the most common complications for mother and fetus. The management methods for these complications were discussed and recommendations for care and treatment were provided. Methods. The literature search was conducted using the „PubMed” database. The most recent covering the topic 'Pregnancy after kidney transplantation' were referenced. Additionally, anonymized data retrospectively collected from the Nephrology and transplantation department of VUL SK was used, focusing on the pregnancies of patients after kidney transplantation, including the course of pregnancy, complications for the mother, fetus, and newborn. Results. The data results consisted of 18 women, with an average age of 28.5 years. According to the study data, the most common complication for women after kidney transplantation during pregnancy was arterial hypertension (55.5%). In 38.8% of women, pregnancy had to be terminated by cesarean section. Anemia was also a common complication (33.3%), kidney function worsened in 5 (27.7%) of women. Four women (22.2%) were diagnosed with preeclampsia and had an increased risk of anomalies (22.2%). A small percentage complained of edema (16.6%), and complications such as infection or hydronephrosis were rarely observed (5.5%). Regarding fetal data, two women gave birth to stillborn babies (11.1%), two had preterm newborns (11.1%), there were two non-developing pregnancies (11.1%), and one miscarriage (5.5%). Additionally, one woman gave birth to a low-birth-weight newborn (<2500 g) (5.5%), and one newborn had acute fetal hypoxia (5.5%). It is important to note that 1 out of 18 women (5.5%) did not experience any complications during pregnancy. The data found in the literature coincided with the study data. Various articles and sources describe the same complications for 7 women during pregnancy after kidney transplantation: hypertension, anemia, preeclampsia, and the recommended termination of pregnancy via cesarean section. Reviewing literature sources, similar complications were found for the fetuses: low birth weight, increased risk of anomalies, and stillbirth. Conclusions. Based on both literature sources and data collected from the Nephrology and transplantation department of VUL SK, pregnancy is not contraindicated for women after kidney transplantation. However, it must be planned in advance and monitored by a multidisciplinary team due to various complications. The greatest risk for women after kidney transplantation during pregnancy is arterial hypertension, pregnancy termination by cesarean section, anemia, and preeclampsia. There is an increased risk of possible fetal anomalies, stillbirth, or low birth weight. Due to these factors, such pregnancies must be carefully monitored to ensure they proceed smoothly and without complications. It is important to pay attention to the drugs women use and especially woman’s immunosuppressive therapy, discontinuing it on time, and only planning the pregnancy when necessary. If immunosuppression is required during pregnancy, it must be non-teratogenic. |
