Chronic renal insufficiency and female reproductive function. Note III: Pregnancy after renal transplantation [Insufficienza renale cronica e funzione riproduttiva femminile. Nota 3.: la gravidanza dopo trapianto renale]

Owing to renal transplantation, it is often possible to achieve parenthood. Pregnancy in a female recipient must be considered at high risk and so monitored. In most women, renal function is augmented during pregnancy but permanent impairment may occur in 15% of cases. Pregnancy in transplanted mothers is related to significant maternal (hypertension, preeclampsia, serious infections) and fetal risks (intrauterine growth retardation, premature labor). Pregnancy is regarded as an immunologically privileged state, incidence of rejection in unusual and it occasionally occurs in puerperium. Modest doses of immunosuppressive and steroid drugs must be continued during pregnancy. The transplanted kidney rarely produces dystocia and it is not injured during vaginal delivery. Caesarean section should be reserved for obstetric reasons only. There are no predominant or frequent developmental abnormalities in children of renal transplantated recipients.