신장 이식을 받은 여성의 임신 - 산모 ,태아 및 이식신에 대한 임신의 안정성 -

Abstract

We retrospectively reviewed 48 pregnancies in 36 female patients after renal transplantation until February, 1998 at Yonsei University College of Medicine. All patients were maintained on cyclo-sporine- based immunosuppressive regimen before, during and after pregnancy. Patients were divided into two groups; group 1 (Delivery Group) of 25 women with 26 pregnancies and group 2 (Abortion Group) of 19 women with 22 pregnancies. Mean interval between renal transplantation and conception is 31.8 22.9 months. Serum creatinine was reported before, during and after pregnancy and there was no significant changes of its mean value in both groups. Mean daily dosage of cyclosporine were similar in patients. Average gestational age was 37.0 2.0 weeks and the incidences of very low birth weight (VLBW), low birth weight (LBW) and small for gestational age (SGA) were 7.7%, 63.5% and 84.6%, respectively. Pregnancy-related complications during pregnancy in group 1 were urinary tract infection in 11 cases, preeclampsia in 7 cases, hypertension in 4 cases and proteinuria in 3 cases. There was no acute rejection or graft loss during pregnancy. The premature deliveries less than 37 weeks were 12 cases (46.2%). Low birth-weight of neonate was significantly related with maternal pre-pregnant hypertension (1793.3 393.0 gm in patients with hypertension vs. 2471.2 468.1 gm in patients without hypertension; p=0.001). Pregnancy in female renal transplant patients is relatively safe while they are monitored in a tertiary care center with close monitoring of cyclosporine A (CsA) dosing, serum creatinine levels and the other laboratory values by a transplant surgeon, nephrologist, obstetrician and pediatrician.