Course of pregnancy and delivery after in vitro fertilization in a patient with a kidney transplant (clinical case)
DOI:
https://doi.org/10.37800/RM.1.2026.654Keywords:
Key words: kidney transplantation, infertility, in vitro fertilization, pregnancy, immunosuppression, pregnancy outcomes.Abstract
Relevance: Currently, there is a global trend of increasing kidney pathology, which often leads to the development of chronic kidney disease. Kidney transplantation is considered the most effective treatment for such patients. It should be noted that fertility disorders occur more frequently in women after kidney transplantation compared to healthy women. Nevertheless, assisted reproductive technologies are rarely used in kidney transplant recipients. One of the potential complications for these women is the risk of transplant kidney dysfunction during pregnancy. Therefore, multidisciplinary counseling is essential to assess risks, determine the optimal timing of pregnancy, and provide preventive medical treatment.
The study aimed to evaluate the outcome of pregnancy and childbirth in a 43-year-old woman with a kidney transplant who conceived via in vitro fertilization.
Materials and Methods: A literature search was conducted in the PubMed database, including both Kazakh and foreign sources, using the study keywords.
A clinical case was analyzed, including the course of pregnancy, medical examinations, delivery, and newborn health outcomes, in a patient who underwent allotransplantation of a donor kidney from a living relative. Pregnancy management and follow-up were conducted at City Polyclinic No. 4 (Almaty, Kazakhstan) in collaboration with specialists from the A.N. Syzganov National Scientific Center of Surgery. The delivery took place at the Center for Obstetrics, Gynecology, and Perinatology (Almaty, Kazakhstan).
Results: A planned caesarean section at 37 weeks of pregnancy resulted in the birth of a healthy boy weighing 2925.0 g, 50 cm in length, with an Apgar score of 7/8 points. The maternal kidney transplant function remained stable, and the postoperative period was uneventful.
Conclusions: Pregnancy at an advanced reproductive age via in vitro fertilization and the delivery of a healthy child in a woman with a kidney transplant can have a favorable outcome. However, this is possible only if the transplant function remains stable throughout gestation. Pregnancy in such patients requires continuous dynamic monitoring by an obstetrician-gynecologist, nephrologist, and transplant specialist, along with regular clinical and laboratory assessments of both maternal and fetal health.
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