Kidney transplantation and pregnancy: experience with 6 patients

From 1983 to 1991, six pregnant women bearing a renal transplant were admitted at the P Universidad Católica de Chile Clinic Hospital. All of them were under immunosuppressive therapy with azathioprine and prednisone. One patient was also receiving cyclosporine. Four had chronic hypertension; 1 presented intrahepatic cholestasis of pregnancy; 2, premature rupture of membranes, and 3, preeclampsia (superimposed to chronic hypertension). There were no abortions. The median gestational age at delivery was 35.5 weeks. Only one of the six newborns was small for gestational age; the others were of appropriate size. There were no neonatal problems or congenital anomalies. Deterioration of the renal function was observed in two patients. One patient presented rejection to the transplanted kidney. Pregnancy following renal transplantation is not exempt of risks, but multidisciplinary management, close prenatal control and opportune interruption of gestation play a key role in the successful outcome of these pregnancies.