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ABSTRACT: Liver transplantations give female recipients an ability to carry pregnancies successfully. However, solid organ transplantations exacerbate the pregnancy including maternal and neonatal outcomes. The aim of our study was to evaluate and identify the obstetric outcomes in women with a prior liver transplantation.
We analyzed all pregnant woman who had undergone a prior liver transplantation and afterward delivered from 2001 to 2011. Complete data were assessed in 39 deliveries and 40 live births. Three women were pregnant twice after liver transplantation.
The mean gestational age at birth measured 37.2±2.2 weeks. The most common obstetric complications were premature labor (12/39,30.8%), hypertension (10/39, 25.6%), and symptomatic urinary tract infections (7/39, 18%). Other complications were pregestational diabetes (n=1), cholestasis (n=3), and of severe anemia treated with blood transfusions (n=2). The mean time from organ transplantation to delivery was 67.6±47.2 months. Acute graft rejections occurred among pregnant women 7.7% (3/39) of studied. Only 8 (20.5%) deliveries were finished vaginally. Infants small for gestational age were diagnosed in 20% (8/40). One case displayed a congenital urinary tract malformation. None of the neonates died neonatally.
Pregnancies are possible after liver transplantation and likely end with successful maternal and newborn outcomes. Some cases experience an increased risk of obstetric complications. Therefore, posttransplant pregnancies must be regularly monitored with a multidisciplinary approach.
Transplantation Proceedings 10/2011; 43(8):3043-7. · 1.00 Impact Factor
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ABSTRACT: Neonates born to mothers, who underwent organ transplantation require close medical monitoring. It is unknown how chronically diseased mother's organs or immunosuppressive drugs affect fetal growth and development; some immunosuppressants are teratogenic and contraindicated during pregnancy. The aim of this study was to determine the prevalence of prematurity and intrauterine growth restriction in neonates born to women who have undergone renal or liver transplantation.
Our retrospective analysis identified 53 (25 renal and 28 liver) cases of neonates delivered by female graft recipients between January 2005 and December 2009. Hypotrophy was defined as a birth weight<10th percentile for gestational age. We excluded newborns diagnosed with severe hypotrophy (<5th percentile).
Neonates born prematurely were predominate in the renal (16/25, 64%), but less than half of the liver cohort (13/28, 46%). Hypotrophy less than the 10th percentile was noted significantly more often among renal than liver recipients; 36% versus 14% (P<.05). Severe hypotrophy was also observed significantly more often among renal than liver transplant neonates: 28% versus 3.6% (P<.001).
Compared with liver insufficiency, chronic kidney diseases have stronger effects on the fetus, leading to adverse neonatal complications. A greater prevalence of preterm births, as well as hypotrophic newborns, especially less than the 5th percentile, was observed among neonates delivered by mothers after kidney transplantation.
Transplantation Proceedings 10/2011; 43(8):3048-51. · 1.00 Impact Factor
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ABSTRACT: We present a case of a female kidney recipient who was infected with 3 types of high-risk human papilloma viruses. An infection in the lower genital tract led to the development of both neoplastic cervical lesions and vulvar cancer.
Transplantation Proceedings 10/2011; 43(8):2994-6. · 1.00 Impact Factor
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ABSTRACT: Pregnancies in renal transplant patients are considered to be high risk. Anemia is one of the major complications of pregnancy occurring among 65% to 85% of cases in this setting, especially since these patients carry additional risk factors. Herein we have presented five renal transplant recipients who were women who were treated with human recombinant erythropoietin due to severe anemia that developed during pregnancy. Hemoglobin levels below 9 g/dL after 3 weeks of oral iron administration were assumed to be qualifying criteria for erythropoietin treatment. No complication was observed to be associated with the treatment. Two of the five patients required blood transfusions despite erythropoietin administration. Two cases delivered small for gestational fetus age. Erythropoietin therapy in pregnant kidney transplant recipients should be considered to be a safe method to reduce the need for blood transfusions.
Transplantation Proceedings 10/2011; 43(8):2970-2. · 1.00 Impact Factor
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Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):132-133. · 3.01 Impact Factor
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ABSTRACT: The aim of the study was to compare general postnatal condition of preterm infants delivered by caesarean section or born vaginally.
The study group consisted of 605 premature newborns delivered in Obstetrics and Gynaecology Clinic of Medical University of Warsaw in 1995-2000. The newborns were divided into two groups. There were 280 prematures delivered by caesarean section in the first group and 325 ones were born vaginally in the second group.
The first day mortality rate in infants born vaginally was 6.8% comparing with 2.8% in ones delivered by caesarean section.
In the study group the percentage of neonatal severe condition was similar in both groups but mortality rate in the first day of life was slightly higher in infants born vaginally.
Ginekologia polska 01/2002; 72(12):1087-91. · 0.41 Impact Factor
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ABSTRACT: The aim of this study was to analyze the postnatal condition and mortality of neonates with extremely low birth weight.
The study group consisted of 35 neonates delivered in the 1st Dept of Ob/Gyn. Medical University of Warsaw in the period of 1996-2000. The group was divided into two classes depending on the birth weight. There were newborns weighted 500-750 g in the first class and 751-1000 g in the second one. Newborns condition in the 1st minute of life was assessed with Apgar score. The rate of mortality up to the 7th day of life as well as the causes of deaths was analyzed.
Postnatal mortality rate of premature newborns extremely low birth weight is still very high, especially in case of newborns below 750 g. Respiratory distress syndrome and intracranial hemorrhage are the most common causes of demise of those newborns.
Ginekologia polska 01/2002; 72(12):1101-6. · 0.41 Impact Factor
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ABSTRACT: Preterm delivery of baby with extremely low birth weight (ELBW) is an important problem in contemporary perinatology and a major reason of perinatal mortality. A great development of neonatal intensive care that has occurred over the last few years has resulted in the decrease of perinatal mortality rate. The aim of the study is to analyse the course of pregnancy, labour and neonatal outcome in the group of patients who delivered ELBW children.
In 1st Obstetric and Gynaecology Department Clinic of Medical University of Warsaw, 6982 deliveries were conducted from 1996 to 2000. Among them there were 589 preterm ones. As a result 44 women delivered ELBW children. These 44 deliveries were divided into three groups according to the reasons: Idiopathic preterm contractility-24 patients PROM with intrauterine infection or threatening infection-14 Induction of delivery because of lethal foetal defects and direct foetal distress-6.
The most common reasons for deliveries of ELBW children were hypertension and ascending infections.
A great number of mothers who delivered ELBW children had low socioeconomic status. In most cases pregnancy was unplanned and body mass index of the mothers was below 19. Almost all these newborns were severely depressed and delivery was often complicated. It is important to conduct labour in a careful way to avoid tissue injuries.
Ginekologia polska 01/2002; 72(12):1121-8. · 0.41 Impact Factor
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ABSTRACT: The aim of the study was to determine the effectiveness of antenatal steroids and ambroxol in reduction of respiratory distress syndrome (RDS) in newborns of diabetic mothers. A retrospective chart review was done on 101 diabetic gravidas who were hospitalised at 1st Department of Obstetrics and Gynaecology Medical University in Warsaw between January 1989 and December 1999. We studied the neonatal outcomes for women with diabetes mellitus who delivered before 37 gestational weeks depend on exposition to antenatal steroids or ambroxol. Both groups were compared with unexposed neonates for respiratory distress syndrome. Frequency of occurrence and severity of RDS were similar in all study subgroups. We did not found reduction of respiratory distress syndrome in newborns of diabetic mothers exposed to antenatal steroids or ambroxol.
Ginekologia polska 09/2000; 71(8):887-92. · 0.41 Impact Factor
