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TRANSPLANTE RENAL E GRAVIDEZ
(especial para SIIC © Derechos reservados)
Nosso grupo, na Universidade Federal de São Paulo - Brasil tem acumulado experiência nesses casos e neste trabalho relatamos nossa experiência comparando com os dados obtidos na literatura. Nós enfatizamos que somente o acompanhamento multiprofissional levará aos melhores resultados.
deoliveira9.jpg Autor:
Leandro Gustavo De Oliveira
Columnista Experto de SIIC
Institución:
Universidade Federal de São Paulo
Artículos publicados por Leandro Gustavo De Oliveira
Coautores
John M Davison* Nelson Sass** José Osmar Medina Pestana** 
Newcastle University, Newcastle upon Tyne, Reino Unido*
Universidade Federal de São Paulo, São Paulo, Brasil**
Recepción del artículo
26 de Diciembre, 2007
Aprobación
22 de Febrero, 2008
Primera edición
1 de Julio, 2008
Segunda edición, ampliada y corregida
21 de Noviembre, 2008

Resumen
Pacientes com insuficiência renal crônica são frequentemente inférteis e a taxa de gravidez gira em torno de 1:200. Perda da libido, disfunção ovariana, amenorréia e elevados níveis de prolactina contribuem para a infertilidade. Após o transplante, entretanto, a fertilidade pode retornar rapidamente e a as taxas de gravidez passam para 1:50. Não há dúvidas de que essas mulheres constituem um grupo de alto risco e de elevadas taxas de problemas tanto maternos quanto perinatais. Desde a primeira gravidez de sucesso em uma portadora de transplante renal relatada em 1963, diversas publicações têm focado maiores incidências de síndromes hipertensivas, anemia, perda da função renal, pré-eclâmpsia, prematuridade, ruptura prematura de membranas, restrição de crescimento fetal e óbito perinatal. Nosso grupo, na Universidade Federal de São Paulo - Brasil tem acumulado experiência nesses casos e neste trabalho relatamos nossa experiência comparando com os dados obtidos na literatura. Nós enfatizamos que somente o acompanhamento multiprofissional levará aos melhores resultados. Por fim, gostaríamos de manifestar o nosso desejo de entrar em contato com outros grupos para discussão desses casos e então aprendermos juntos.

Palabras clave
insuficiência renal crônica, gravidez, transplante renal, drogas imunossupressoras


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página  www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Trasplantes
  Relacionadas: Nefrología y Medio InternoObstetricia y Ginecología

Enviar correspondencia a:
Leandro Gustavo de Oliveira, Departamento de Obstetrícia da Universidade Federal de São Paulo - Brasil., CEP: 04024, Rua Napoleão de Barros, 875., São Paulo, Brasil

Artículo completo

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Renal Transplantation and Pregnancy

Abstract
Patients with chronic renal insufficiency are frequently infertile and the incidence of pregnancy is 1:200. Loss of libido, ovarian dysfunction, anovulatory vaginal bleeding, amenorrhea and high prolactin levels, all contribute to this infertility. However, after renal transplantation fertility can return rapidly with the chances of pregnancy increasing to about 1:50. There is no doubt that these women are a special high risk group with the potential for both maternal and perinatal problems. Since the first successful pregnancy was reported in 1963 many other publications have emphasized the increased incidence of hypertension, anaemia, renal function deterioration, pre-eclampsia, preterm delivery, preterm rupture of membranes, fetal growth restriction and stillbirths. At the Federal University of Sao Paulo - Brazil, we have emphasized that a multidisciplinary team approach is essential for their care and in this article we document and analyze the lessons learnt from our significant single centre experience. We would be happy in contacting other groups of specialists interested in this special group of patients to discuss and learn together.


Key words
chronic renal insufficiency, pregnancy, renal transplantation, immunosupresor drugs

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10. O'Connell PJ, Caterson RJ, Stewart JH, Mahony JF. Problems associated with pregnancy in renal allograft recipients. Int J Artif Organs 12:147-52, 1989.
11. Davison JM. Dialysis, Transplantation and pregnancy. Am J Kidney Dis 17:127-32, 1991.
12. Shohaib SA. Erythropoietin therapy in a pregnant post-renal transplant patient. Nephron 81:81-3, 1999.
13. Bakr MA, Ghaneim MES, Fouda MA, Sally S, Moustafa FE, Sobh MA, Ghoneim MA. Clinical course and outcome of pregnancies recipients of renal allografts. Transplant Proc 29:2787-9, 1997.
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34. Packham DK, Lam SS, Nicholls K, Fairley KF, Kincaid-Smith P. Mycophenolato mofetil in pregnancy after renal tranplantation: a case of major fetal malformation. Obstet Gynecol 103(5PT2):1091-4, 2004.
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Especialidad principal:
Trasplantes

Relacionadas:
 Nefrología y Medio Interno
 Obstetricia y Ginecología
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