Pregnancy after kidney transplantation, recommendations of reference and its course

Modern medicine allows you to lead a pregnancy after kidney transplantation, but with special rules and doctors recommendations.

Reasons for transplantation and subsequent pregnancy

On the background of the development of chronic kidney failure, most women suffer from dysfunction of the gonads, which is characterized by ovarian insensitivity to the influence of tropic hormones produced by the pituitary gland. This leads to violations of the cycle of menstruation.

The most suitable method of treatment for patients with terminal stage of kidney failure is organ transplantation. The doctors found that a successful operation can significantly restore the quality of life of a woman.

After successful kidney transplantation, the menstrual function is restored for 7 months in 60% of patients.

The interval between the operation and the onset of pregnancy should not be less than 12 to 18 months. Usually by this time stabilization of the transplanted kidney is achieved. Under the condition of low doses of immunosuppressants, the risk of manifestation of the reaction of rejection or adverse effect of drugs on the fetus is reduced.

The most suitable time for pregnancy is 2 to 7 years after transplantation. It is not advisable to have a child at a later date, because the possibility of forming chronic nephropathy in the transplant is increased.

Pregnancy pregnancy

During pregnancy, a woman with a transplanted kidney may experience some specific complications. One of the most frequent abnormalities is anemia. Almost all women with chronic kidney deficiency, consisting of hemodialysis, develop anemia, but even after a successful transplant operation there is a risk of anemia. It provokes the use of immunosuppressants and other drugs that suppress the normal operation of the bone marrow.

Erythrocytosis is formed in 20% of women after kidney transplantation. But during pregnancy, erythropoietin deficiency, with normal kidney function and lack of chronic rejection, correlates with a high need for this substance due to gestation processes.

Another common complication is pyelonephritis of the transplanted kidney. The reason for pyelonephritis involves the development of disturbances in urodynamics, which leads to the widening of the lumen of the upper canals of urination. Such changes are clearly manifested in the second and third trimester of pregnancy. After delivery, regression occurs four to eight weeks later.

In the main infection of the urinary canals during pregnancy is observed in those women, the cause of kidney failure in which was pyelonephritis. Diagnostic signs of pyelonephritis are an increased concentration of leukocytes and bacteria in the urine.

Recommendations for the management of pregnancy

The management of pregnancy in patients with a transplanted kidney depends primarily on the assessment of risk levels, as well as on the impact of the process on the prenatal development of the child and on his future state of health.

The control of the course of pregnancy for women with a transplanted kidney is performed simultaneously by a nephrologist and gynecologist. Carefully monitoring the work of the transplant, the condition of the patient and the child is an indispensable condition for the successful completion of pregnancy.

All women with a transplanted kidney require a prophylactic intake of plant-derived uroseptics during the entire period of gestation.

When anemia develops, the doctor prescribes the administration of iron preparations.

Any woman who undergoes transplantation undergoes immunosuppressive treatment. Since the establishment of pregnancy is prohibited further administration of such drugs because of the possibility of teratogenic effects.

Childbirth and the puerperium

In women, it is preferable to organize birth through caesarean section.

Any patient who has suffered infection of the urinary canals during pregnancy or after the birth of the child, even if there is no evidence of the presence of white blood cells in the urine and clinical signs of pyelonephritis, receive vegetable uroseptics in the next three months.

Breastfeeding is prohibited because of the possibility of penetration of immunosuppressants into milk.

Forecasts

The flow and completion of pregnancy in women with a transplanted kidney depends entirely on the initial functioning of the donor kidney, the correct conduct of immunosuppressive therapy for the time of bearing and birth.

Interruption of the pregnancy process can worsen the work of the transplant, therefore, in the absence of medical and other contraindications, it is recommended to preserve it. The doctor should carefully monitor the health of such a patient and monitor even minimal changes in her state of health to provide timely help and prevent complications.