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Pregnancy in the mother post organ transplant 

Pregnancy in the mother post organ transplant
Chapter:
Pregnancy in the mother post organ transplant
Author(s):

Harini Narayan

DOI:
10.1093/med/9780199673643.003.0020
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date: 04 December 2020

This chapter addresses pregnancy following kidney and other solid organ transplants . Pregnancy after renal transplantation is not uncommon with successful outcome rates of 95–97% reported when pregnancy progresses beyond the first trimester. Pregnancies following lung, liver, and heart transplantation are high risk due to complication rates and need close multidisciplinary input. Prognosis, pregnancy complications, expected outcomes, and multidisciplinary management shared with tertiary centres are detailed, based on transplantation pregnancy registers, up-to-date literature, and best practice evidence. Pre-pregnancy evaluation, deferring pregnancy for 12–18 months after transplant, smoking cessation, prevention of infections, and continuation of immunosuppressants compatible with pregnancy are discussed. Timing of vaccinations before transplantation is highlighted. Monitoring with vigilance for hypertension, pre-eclampsia, urinary tract infections, fetal growth, renal and liver function, cytomegalovirus serology, serum levels of immunosuppressants, etc., are addressed. Clear documentation of plans for mode of delivery, intrapartum/postnatal care, breastfeeding, immunosuppressant therapy, thromboprophylaxis and contraception are highlighted.

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