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目的探讨肾移植患者的妊娠结局及其相关因素。方法回顾性分析我院2000年1月至2007年12月5例肾移植患者的6次妊娠,收集患者的产科资料、移植相关并发症、血肌酐水平、血压、分娩情况,随访新生儿、患者移植肾的结局。结果5例患者6例次妊娠,4例次期待妊娠,其中2例次妊娠成功,分别于孕37周及孕36周分娩,新生儿出生体重分别为3025g和3070g,新生儿无明显异常。2例次妊娠因重度子痫前期在孕中期行治疗性引产,其中1例受孕后降低免疫抑制剂的用量,引产术后两年肾功能进行性受损,1年后实施了对侧肾移植术;另1例患者受孕后停用免疫抑制剂,在孕中期出现重度子痫前期、心力衰竭、重度贫血、肾功能恶化,行治疗性引产。结论肾移植是生育年龄终末期肾脏疾病患者最好的治疗方式,但妊娠对于孕妇、胎儿、新生儿及移植肾都有一定的危险。孕期降低或停用免疫抑制剂是不良妊娠结局的重要原因。肾移植患者妊娠最常见的妊娠并发症是子痫前期。
Objective To investigate the pregnancy outcome and related factors in renal transplant recipients. Methods A retrospective analysis of our hospital from January 2000 to December 2007 5 cases of renal transplant patients with 6 pregnancies, the patient’s obstetric data collection, complications related to transplantation, serum creatinine, blood pressure, delivery, follow-up of newborns, patients Kidney transplant outcomes. Results Of the 5 patients, 6 were pregnant and 4 were pregnant. Two of them were successful in their second trimester of pregnancy. They were delivered at 37 weeks of gestation and 36 weeks of gestation. The newborn’s birth weights were 3025g and 3070g, respectively. There was no obvious abnormality in newborns. 2 cases of secondary pregnancy due to severe preeclampsia in the second trimester of therapeutic induction of labor, including 1 case of pregnancy reduced the amount of immunosuppressive agents, induced abortion two years after the progressive impairment of renal function, contralateral kidney transplantation was implemented after 1 year Another patient was immunosuppressed after conception, with severe preeclampsia, heart failure, severe anemia and worsening renal function in the second trimester. Conclusion Kidney transplantation is the best treatment for end-stage renal disease in children of childbearing age. However, pregnancy has certain risks for pregnant women, fetuses, newborns and transplant kidneys. Decreased or suspended during pregnancy immunosuppressive agents is an important cause of adverse pregnancy outcomes. The most common pregnancy complication of pregnancy in kidney transplant patients is preeclampsia.