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Grossesse après transplantation rénale : expérience du service de transplantation rénale du CHU Ibn Sina de Rabat (Maroc).

Auteurs : Driouch L1, Azzouzi A1, Ouzeddoun N1, Benamar L1, Bayahia R1, Bouattar T1
Affiliations : 1Service de néphrologie, dialyse et transplantation rénale, CHU Ibn Sina, Rue Mfadel Cherkaoui, quartier Souissi, 10100 Rabat, Maroc.
Date 2023 Mars 15, Vol 19, Num 1, pp 1-11Revue : Néphrologie et ThérapeutiqueType de publication : résumé en anglais; article de périodique; DOI : 10.1684/ndt.2023.2
Résumé

Kidney transplantation (KT) restores the fertility of women with end-stage kidney disease (ESKD), thus offering them the possibility of having children. However, pregnancy after kidney transplantation is associated with high maternal-fetal morbidity. The purpose of this work is to report the experience of our service in pregnancies in kidney transplant recipients.We retrospectively studied the records of transplant recipients who had one or more pregnancies after KT. We analyzed clinical (blood pressure, weight gain, oedema, duration of pregnancy, obstetric complication) and biological (creatinine, urinary albumin excretion) parameters.Between 1998 and 2020, twenty-one pregnancies occurred in 12 transplant recipients. The average age of patients at the time of conception was 29 ± 5 years with a delay between KT and pregnancy of 43 ± 29 months. Seven pregnancies began with arterial hypertension (HTA) controlled under treatment, proteinuria before conception was negative in all pregnancies and renal function was normal with an average creatinine level of 10.1 ± 1,27 mg/L. Prior to pregnancy, immunosuppression regimens were based on anticalcineurin (n = 21) combined either with mycophenolate mofetil (MMF) (n = 10) or azathioprine (n = 8) or alone (n = 3). Immunosuppression regimens were all associated with corticosteroid therapy. Three months before conception, MMF was relayed by azathioprine in seven pregnancies, on the other hand three other unplanned pregnancies, started under MMF. During pregnancy, the appearance of proteinuria greater than 0,5 g/24 h was noted in three pregnancies in the third trimester. Pregnancy hypertension was found in three pregnancies, one of which progressed to pre-eclampsia. As for renal function, it remained stable with an average creatinine level of 10,3 mg/l in the 3rd trimester. Two cases of acute p...Dans notre service, un quart des transplantées a pu mener une grossesse avec une productivité de 89 % de ces grossesses. La grossesse après la TR nécessite une planification et une surveillance particulière. Une collaboration multidisciplinaire entre néphrologue transplanteur, gynécologue et pédiatre est nécessaire en se référant aux recommandations.

Mot-clés auteurs
pregnancy; eskd; immunosuppression; kidney transplantation;
 Source : MEDLINE©/Pubmed© U.S National Library of Medicine
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Driouch L, Azzouzi A, Ouzeddoun N, Benamar L, Bayahia R, Bouattar T. Grossesse après transplantation rénale : expérience du service de transplantation rénale du CHU Ibn Sina de Rabat (Maroc). Néphrologie et Thérapeutique. 2023 Mar 15;19(1):1-11.
Courriel(Nous ne répondons pas aux questions de santé personnelles).
Dernière date de mise à jour : 29/03/2023.


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