vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2024-2-8-15vtio-1739Research ArticleКлиническая трансплантологияClinical TransplantologyБеременность после трансплантации почки: особенности течения, осложнения и исходыPregnancy after kidney transplantation: clinical features, complications and outcomesПрокопенкоЕ. И.ProkopenkoE. I.

Прокопенко Елена Ивановна

129110, Москва, ул. Щепкина, д. 61/2

Тел. (495) 681-55-85

Elena Prokopenko

61/2, Shchepkina str., Moscow, 129110

Phone: (495) 681-55-85

renalnephron@gmail.comНикольскаяИ. Г.NikolskayaI. G.

Москва

Moscow

nikolskaya.55@bk.ruВатазинА. В.VatazinA. V.

Москва

Moscow

vatazin@yandex.ruБурумкуловаФ. Ф.BurumkulovaF. F.

Москва

Moscow

fatima-burumkulova@yandex.ruГубинаД. В.GubinaD. V.

Москва

Moscow

penzevadv@yandex.ruГБУЗ МО Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского; ГБУЗ МО Московский областной научно-исследовательский институт акушерства и гинекологииРоссияVladimirsky Moscow Regional Research and Clinical Institute; Moscow Regional Research Institute of Obstetrics and GynecologyRussian FederationГБУЗ МО Московский областной научно-исследовательский институт акушерства и гинекологииРоссияMoscow Regional Research Institute of Obstetrics and GynecologyRussian FederationГБУЗ МО Московский областной научно-исследовательский клинический институт им. М.Ф. ВладимирскогоРоссияVladimirsky Moscow Regional Research and Clinical InstituteRussian Federation202429022024262815Copyright © Прокопенко Е.И., Никольская И.Г., Ватазин А.В., Бурумкулова Ф.Ф., Губина Д.В., 20242024Прокопенко Е.И., Никольская И.Г., Ватазин А.В., Бурумкулова Ф.Ф., Губина Д.В.Prokopenko E.I., Nikolskaya I.G., Vatazin A.V., Burumkulova F.F., Gubina D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1739

Беременность у пациенток после трансплантации почки (ТП) стала встречаться чаще, однако риск осложнений и неблагоприятных акушерских исходов в этой группе женщин остается высоким.

Цель

Цель: изучить осложнения и исходы беременности у пациенток с трансплантированной почкой, выживаемость ренальных трансплантатов (РТ) после родов.

Материалы и методы

Материалы и методы. В исследование включены 22 беременности у 20 женщин с РТ (трансплантации выполнены в 2006–2020 гг.), группу сравнения составили 20 здоровых женщин, у которых было 20 беременностей. Оценивалась частота и характер осложнений беременности, показатели здоровья новорожденных, исходы беременности. Выживаемость трансплантатов сравнивалась в основной группе и в группе 102 женщин после ТП, не имевших беременностей.

Результаты

Результаты. У реципиенток РТ в сравнении со здоровыми женщинами выше была частота преэклампсии – 25 и 0%, p = 0,047, задержки роста плода – 30 и 0%, p = 0,020, гестационного диабета – 40 и 5%, p = 0,020, бессимптомной бактериурии – 35 и 5%, p = 0,044, преждевременных родов – 60 и 0%, p < 0,001, кесарева сечения – 70 и 10%, p < 0,001. Медиана срока родов и массы детей при рождении была значимо ниже у женщин с РТ: 36,0 [33,9; 37,4] в сравнении с 38,9 [38,9; 39,6] нед., p < 0,001, и 2405 [2023; 2958] в сравнении с 3355 [3200; 3690] г, p < 0,001, соответственно. Частота благоприятных исходов беременности после ТП составила 81,8%, а без учета ранних потерь беременности – 90%. У двух детей выявлены наследственные заболевания с передачей от матери. Выживаемость трансплантатов не различалась у реципиенток РТ, имевших и не имевших беременности, p = 0,272.

Выводы

Выводы. Исходы беременности у пациенток с РТ в целом благоприятны, вынашивание беременности и роды не влияют на выживаемость трансплантатов. При планировании беременности после ТП необходимо учитывать риск осложнений и возможность передачи потомству наследственных заболеваний.

Pregnancy after kidney transplantation (KT) has become more common, but the risk of complications and adverse obstetric outcomes in this group of women remains high.

Objective

Objective: to study pregnancy complications and outcomes in kidney recipients and renal graft (RG) survival after childbirth.

Material and methods

Material and methods. The study included 22 pregnancies in 20 women with RG (transplants performed in 2006–2020). The comparison group consisted of 20 healthy women who had 20 pregnancies. Frequency and nature of pregnancy complications, neonatal health indicators, and pregnancy outcomes were evaluated. Graft survival was compared in the main group and in a group of 102 women after KT who did not have pregnancies.

Results

Results. Compared with healthy women, RG recipients had a higher rate of preeclampsia (25% and 0%, p = 0.047), fetal growth restriction (30% and 0%, p = 0.020), gestational diabetes (40% and 5%, p = 0.020), asymptomatic bacteriuria (35% and 5%, p = 0.044), preterm birth (60% and 0%, p < 0.001), and cesarean section (70% and 10%, p < 0.001). Median gestational age and birth weight were significantly lower in women with RG: 36.0 [33.9; 37.4] vs. 38.9 [38.9; 39.6] weeks, p < 0.001, and 2405 [2023; 2958] vs. 3355 [3200; 3690] g, p < 0.001, respectively. The rate of favorable pregnancy outcomes after KT was 81.8%, or 90% when early pregnancy loss is excluded. Two children were found to have genetic diseases passed from the mother. Graft survival did not differ between RG recipients with and without pregnancy, p = 0.272.

Conclusions

Conclusions. Pregnancy outcomes in patients with RG are generally favorable, pregnancy and childbirth do not affect graft survival. When planning pregnancy after KT, it is necessary to consider the risk of complications and the possibility of transmitting genetic disorders to offspring.

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The authors declare that there are no conflicts of interest present.