Pregnancy After Kidney Transplantation
Özet
Kidney transplantation is the kidney replacement therapy method with the highest probability of restoring reproductive potential in women with advanced chronic kidney disease. Following a successful transplant, ovulatory cycles and spontaneous fertility often return within the first few months, frequently within the first six months; this makes pregnancy a realistic possibility for many women who were subfertile during dialysis or in the course of advanced renal failure. However, pregnancy should never be considered a routine occurrence in kidney transplant recipients. Pregnancy is a high-risk clinical situation, carrying not only the physiological burden of pregnancy itself but also the combined effects of chronic kidney disease, a single functioning graft, the need for lifelong immunosuppression, and the associated disease burden of hypertension, proteinuria, and the risk of infection. Despite all these challenges, current data are generally encouraging with careful planning. Data from registry systems and meta-analyses show that live births are possible in the majority of pregnancies following kidney transplantation, with live birth rates often ranging from approximately 73–79%. These findings demonstrate that successful motherhood is possible in this patient group. However, despite acceptable live birth rates, rates of hypertensive pregnancy disorders, preterm birth, cesarean section, and fetal growth restriction are significantly higher compared to the general obstetric population. Therefore, the primary goal of care is not only to allow pregnancy but also to ensure conception occurs at the safest possible time and under the most appropriate clinical conditions.
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