肾移植术后妊娠三例报告及文献复习

Pregnancy after renal transplantation:report of 3 cases and review of the literature

目的探讨肾移植术后妊娠及分娩对移植肾功能及新生儿的影响。方法观察分析3例女性肾移植患者妊娠及分娩过程移植肾功能及新生儿健康状况指标。3例患者年龄分别为32、31和31岁。肾移植术后均接受环孢素（CsA）、硫唑嘌呤（Aza）和浚尼松三联免疫抑制治疗方案。分别于肾移植后35、34、43个月妊娠。结果3例患者妊娠过程中均未发生急性排斥反应，移植肾功能未出现异常。发生先兆子瘸2例。3例患者分别于孕第34、38和37周实施剖腹产手术，过程顺利。新生儿体重分别为2350、3800和3800g．新生儿Apgar评分均为10分。随访14—46个月，患者移植肾功能及新生儿生长发育均未见异常。结论肾移植术后肾功能正常的育龄妇女可以成功妊娠和生产。

Objective To evaluate the effects of pregnancy and delivery on allagraft function and newborns in renal transplant recipients. Methods The effects of pregnancy and delivery on allograft function and newborns in 3 renal transplant recipients were observed and analyzed, The age of the 3 recipients was 32,31 and 31 years ,respectively, at pregnancy. They all received triple immunosuppressive therapy （CSA ＋ AZA ＋ prednisone） for the prevention of acute rejection after renal transplantation. Results No acute rejoction occurred during pregnancy, and the liver and renal functions were normal in the 3 patients. Preeclampsia occurred in 2 of them. Caesarean section was performed successfully on them at 34,38 and 37 gesrational weeks,respectively. The weight of the neonates was 2350 g,3800 g and 3800 g, respectively; and the Apgar scores of the newborns were all 10. （ Apgar scores include appearance, pulse, grimace, activity, and respiration. Apgar score 38 means newborns in healthy status）. After follow-up for 14 -46 months, there was no abnormity of the function of transplanted renal and the upgrowth of the newborns. Conclusions Successful pregnancy and delivery are possible in renal transplant recipients with normal renal function.