异体肾移植12例患者肾功能与子痫前期及妊娠结局的相关性分析OA

Objective By analyzing changes in renal function before and during pregnancy in patients after allogeneic kidney transplantation,and their correlation with preeclampsia and pregnancy outcomes,this study aims to explore the impact of pre-pregnancy assessment and prenatal management on pregnancy outcomes.Methods Select 12 cases of pregnant patients after renal transplantation at the Obstetrics Department of the First Affiliated Hospital of Xi'an Jiaotong University between August 2020 and April 2024.Record data including interval from transplantation to pregnancy,use of immunosuppressive agents,renal function before and during pregnancy,obstetric complications,gestational age and mode of delivery,neonatal follow-up during hospitalization(neonatal weight,Apgar scores).Results The average interval from transplantation to pregnancy was 5.6 years(1.4-9.9 years).Three of the 10 patients who received tacrolimus-based immunosuppressants developed preeclampsia,while two of the two patients who received cyclosporine-based immunosuppressants developed preeclampsia.Five patients developed preeclampsia,and the incidence of fetal intrauterine growth restriction was significantly higher in the preeclampsia group than in the non-preeclampsia group(P=0.003),There was no significant difference in renal function between the two groups.There was no significant change in renal function before pregnancy compared to the early pregnancy period,but there were significant differences in serum creatinine,eGFR in the Mid-pregnancy period,and eGFR in the late pregnancy period compared to the pre-pregnancy period(P=0.02,P=0.02,P=0.03).Conclusions Close monitoring of renal function before and during pregnancy is essential.Pre-pregnancy and gestational serum creatinine and eGFR levels are closely associated with pregnancy outcomes.The transplanted kidney can undergo adaptive changes in response to pregnancy progression,though these adaptations may be limited compared to those of a native kidney.A multidisciplinary team's careful evaluation of the optimal timing for pregnancy before conception and strict blood pressure control during pregnancy are crucial for improving pregnancy outcomes.