#5094 PREGNANCY OUTCOME AFTER KIDNEY TRANSPLANTATION AND IMPACT ON GRAFT FUNCTION

Abstract

Abstract Background and Aims Within 2 to 3 weeks of a successful renal transplantation, the fertility of women in childbearing age improves; however, pregnancy after kidney transplantation is challenging and may be associated with serious maternal and fetal complications. To study the prevalence of pregnancy and pregnancy related complication after kidney transplantation. Method Retrospective cohort study conducted on 236 patients out of 3000 kidney transplant recipient who underwent renal transplantation (RT) at Mansoura Urology and Nephrology Centre between March 1976 and December 2019, divided into two groups, group I; 118 kidney transplant recipient who experienced pregnancy at any time after kidney transplantation and Group II; 118 kidney transplant recipients who didn`t experience pregnancy after renal transplantation, they were matched according to age, duration of renal transplantation and they are comparable in primary immunosuppressant drugs. All kidney recipients were reviewed for preoperative, operative, and post-operative details also we record maternal and fetal complication. Results Prevalence of pregnancy in our centre is 191 pregnancies in 118 women who had underwent kidney transplantation between 1976 and 2019. We have found that the mean age of pregnancy between (26.27±4.37 - 29.89±4.6), the mean gestational age between (33.69±6.4 - 33±7.5) weeks, the live birth rate is 126 (66%). Preterm delivery rate in our study is 85 (44.5%), neonatal death 8 (4.1%), miscarriage 59 (30.9%), intrauterine foetal death 6 (3.1%) and birth defect 4 (2%). The prevalence rates of gestational hypertension is 87 (45.5%), preeclampsia 48 (25.1%), gestational diabetes 19 (9.9%), urinary tract infection 36 (18.8%), and graft rejection 8 (4.1%) during pregnancy. caesarean section is the most common method of delivery in our study 133 (69.6%). Conclusion The risk of maternal and fetal complications is still high in RT patients and requires multidisciplinary care. All should be considered in patient counselling and clinical decision making. So we recommend educating the transplanted patients to allow for outcome optimization and minimization of complications.