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Chapter 46 - Pregnancy after Renal Transplantation

from Section 7 - Hepato-Renal and Gastrointestinal Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Tiina Podymow ,
Amira El-Messidi  and
Michelle Hladunewich
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 38-year-old primigravida is a recipient of a renal transplant. She is referred by her primary care provider for consultation and prenatal care of a spontaneous pregnancy at 10 weeks’ gestation by dating sonogram. She takes prenatal vitamins and has no obstetric complaints.

Keywords

Renal transplantation, allograft, pregnancyComorbiditiesInvestigations, prenatalBacteriuriaPregnancy prognosticatorsPerinatal risks, complications, maternal-fetal morbidity, adverse outcomeImmunosuppressive treatment, pharmacology, mycophenolate mofetil, prednisoneMaternal corticosteroids, complicationsAntenatal managementAcute renal graft rejectionObstetric deliveryCesarean delivery, maternal corticosteroid stress dosesRenal donor, pregnancy
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 584 - 594
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

Bramham, K. Pregnancy in renal transplant recipients and donors. Semin Nephrol. 2017;37(4):370–377.CrossRefGoogle ScholarPubMed
Chandra, A, Midtvedt, K, Åsberg, A, et al. Immunosuppression and reproductive health after kidney transplantation. Transplantation. 2019;103(11):e325–e333.CrossRefGoogle ScholarPubMed
Hladunewich, MA, Melamed, N, Bramham, K. Pregnancy across the spectrum of chronic kidney disease. Kidney Int. 2016;89(5):995–1007.Google Scholar
Hui, D, Hladunewich, MA. Chronic kidney disease and pregnancy. Obstet Gynecol. 2019;133(6):1182–1194.Google Scholar
McKay, DB, Josephson, MA, Armenti, VT, et al. Reproduction and transplantation: report on the AST Consensus Conference on Reproductive Issues and Transplantation. Am J Transplant. 2005;5(7):1592–1599.Google Scholar
Shah, S, Venkatesan, RL, Gupta, A, et al. Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review. BMC Nephrol. 2019;20(1):24.CrossRefGoogle ScholarPubMed
Wiles, K, Chappell, L, Clark, K, et al. Clinical practice guideline on pregnancy and renal disease. BMC Nephrol. 2019;20(1):401.Google Scholar

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