Pregnancy in Women With Solid-Organ Transplants. Issue 6 (June 2015)

• Record Type: Journal Article
• Authors: Durst, Jennifer K.; Rampersad, Roxane M.
• Is Part Of: Obstetrical & gynecological survey. Volume 70:Issue 6(2015)
• Publication Date: 2015-06
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; Generative organs, Female -- Surgery -- Periodicals; 618
• DOI: 10.1097/OGX.0000000000000194
• Languages: English
• ISSNs: 0029-7828

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Importance</title> <p>Advances in solid-organ transplantation have allowed many women to reach reproductive potential, and pregnancy is no longer a rarity for these women.</p> </sec> <sec> <title>Objective</title> <p>To identify (1) potential complications to allograft function posed by pregnancy, (2) expected perinatal outcomes in women with solid-organ transplants, (3) risks of potential immunosuppressant regimens, (4) safety of lactation, and (5) contraceptive options for women with solid-organ transplants.</p> </sec> <sec> <title>Evidence Acquisition</title> <p>Single-center, registry data, and previous systematic reviews were evaluated in women with solid-organ transplants to identify the objectives of this review. In addition, recommendations from public health organizations were examined in regard to safety of medications and contraceptive methods.</p> </sec> <sec> <title>Results</title> <p>Women with solid-organ transplants are at risk for premature birth, low birth weight, cesarean delivery, and hypertensive disorders of pregnancy. Most immunosuppressant regimens are safe; however, mycophenolate mofetil should be avoided. Lactation with tacrolimus, cyclosporine, azathioprine, and prednisone appears safe. Long-acting reversible contraceptive methods are safe and effective for transplant recipients.</p> </sec> <sec> <title>Conclusions</title> <p>Many successful pregnancies have been achieved in women following transplantation; however, optimal perinatal outcomes require stable allograft function.</p> </sec> <sec> <title>Relevance</title> <p>As more women are becoming pregnant after organ transplantation, a review of obstetric recommendations and perinatal outcome is warranted.</p> </sec> <sec> <title>Target Audience</title> <p>Obstetricians and gynecologists, family physicians</p> </sec> <sec> <title>Learning Objectives</title> <p>After completing the activity, the learner should be better able to: identify potential maternal and neonatal complications in women undergoing pregnancy following solid-organ transplantation; explain the important preconceptual considerations for the female transplant recipient; identify potential fetal risk of immunosuppressive regimens and optimal therapy prior to conception; assess the relative compatibility of certain immunosuppressive medications with breast-feeding; recommend safe and effective contraception to the transplant recipient.</p> </sec> </abstract>