Renal transplantation and pregnancy

Abstract

Patients with chronic renal insufficiency are frequently infertile and the incidence of pregnancy is 1:200. Loss of libido, ovarian dysfunction, anovulatory vaginal bleeding, amenorrhea and high prolactin levels, all contribute to this infertility. However, after renal transplantation fertility can return rapidly with the chances of pregnancy increasing to about 1:50. There is no doubt that these women are a special high risk group with the potential for both maternal and perinatal problems. Since the first successful pregnancy was reported in 1963 many other publications have emphasized the increased incidence of hypertension, anaemia, renal function deterioration, pre-eclampsia, preterm delivery, preterm rupture of membranes, fetal growth restriction and stillbirths. At the Federal University of Sao Paulo - Brazil, we have emphasized that a multidisciplinary team approach is essential for their care and in this article we document and analyze the lessons learnt from our significant single centre experience. We would be happy in contacting other groups of specialists interested in this special group of patients to exchange points of view and learn together.