Sammendrag
Kidney transplant recipients (KTR) have a good outcome of pregnancies. However the mother and the child are increasingly at higher risks of complications compared to the general population. The
management of these pregnancies is associated with greater challenges and is better if managed by both the obstetrician and the transplant physician. Kidney transplant is available in few centres in Nigeria and the post transplant population is increasing, but to our knowledge no report on pregnancy management in KTR has been published. We present a 25 years old Nigerian who had a live related kidney transplant and later had 3 consecutive pregnancies and review the relevant literature. She was placed on oral contraceptive pills for 2 years after transplantation. She enjoyed a stable allograft function with no rejection episode, no proteinuria, had a good blood pressure control and pelvic ultrasound scan was essentially normal. She conceived her first pregnancy 26 months post transplant however she developed spontaneous abortion at 3 months gestation. She conceived her second pregnancy 33 months post transplant which was supervised by the obstetrician and the transplant physician. She had complications including urinary tract infection, anaemia and dyslipidaemia and delivered a live baby girl weighing 2.4 Kg by spontaneous vaginal delivery at 36 weeks gestation. She conceived her 3rd pregnancy 8 months later which was also carried to term and had a vaginal delivery of a live baby girl weighing 2.55kg. This report highlights the successful management of pregnancies in KTR and the challenges faced in a poor resource setting.
Keywords: Pregnancy, kidney transplant, Nigeria
Résumé
Les récipients de greffe des reins ont des bons résultats de la grossesse. Cependant, la mère et l’enfant sont constamment exposes a des complication plus élevées compares a la population entière. Les soins de ces grossesses sont associes a des défis considérables et mieux ménages par l’obstétricien et spécialiste en greffe. La greffe des reins est disponible dans quelques centres au Nigeria la population des individus post greffage est en augmentation, mais à notre connaissance aucun rapport sur les soins en grossesse n’a été publies. Nous présentons une femme Nigériane de 26 ans qui avait une greffe de reins et a eu trois grossesses consécutives. Elle était reçue une pilule orale de contraception pendant 2 ans après la transplantation. Elle aimait une allogreffe stable sans épisode de rejection, ni protéinurie, avait une pression artérielle normale et un scan pelvien essentiellement normal. Elle a eu une première grossesse à 26 mois post-greffe mais développait un avortement spontanée à 3 mois de gestation. Elle a eu une deuxième grossesse à 33 mois post-greffe qui était supervisée par un obstétricien et un spécialiste en greffe. Elle avait
complications telles que l’infection urinaire, anémie et dyslipidémie et accouchait d’un bébé fille pesant 2.4 Kg par accouchement vaginal spontanée à 36 semaines de gestation. Elle eut son 3r d grossesse à 8 mois plutard qui est porte jusqu’à terme et avait un accouchement vaginal d’un bébé fille pesant 2.55kg. Ce rapport illumine le succès des soins de ces grossesses et les défis dans les pays sous développés.
Correspondence: Dr. Aliyu Abdu, Department of Medicine, Aminu Kano Teaching Hospital, PMB 3452, Kano, Nigeria. E-mail: aliyuabdu2000@yahoo.co.uk
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