Objectives: The dream to be pregnant in chronic renal failure women of child bearing age after renal transplantation has become reality. Our aim was to evaluate the graft, maternal and fetal outcomes in renal transplant recipient who became pregnant from 1989 to 2005 in our center.
Methods: We retrospectively analyzed 20 pregnancies in 12 renal transplant recipients from data of the hospital records and outpatient questionnaire.
Results: Twelve patients (19 %) of our renal transplant females of child bearing age became pregnant. Mean age at pregnancy was 30.5±4.5 years and mean interval from transplantation to pregnancy was 21±5.7 months. Mean serum creatinine (SCr) before pregnancy was 110.25±24.3 umol/l (77-189). Mean SCr 6 months post delivery was 156 +/- 190.1 (P 0.2). Long term SCr was 194 +/- 274.5 (P 0.08). All patients were normotensive prepregnancy except two were hypertensive and none was markedly proteinuric. One acute rejection episode was reported. Graft loss one year post delivery occurred in 2 patients (one with high starting SCr >132umol/l and the other with short interval from transplantation to pregnancy <1 year) with current mean SCr in the remaining 10 patients is 105 +/- 18.2 umol/l. Complications during pregnancy were; pre-eclampsia in (25%), UTI (25%), preterm delivery <37w (30%) and none of the pregnancies ended by abortion. Normal vaginal delivery vs cesarean section was 70% vs 30% respectively. Gestational age at delivery was 36.3 +/- 3.9 weeks; mean fetal birth weight was 2349.55 +/- 574.35 gm. Among the 20 babies; Apgar score was 9 -10 in all of them, none of the babies was reported to have intrauterine growth retardation or congenital anomalies.
Conclusion: Not only single but also consecutive pregnancies are quite possible after kidney transplantation. The major risk factors are high starting serum creatinine, high starting blood pressure and short time interval from transplantation to pregnancy.