ABSTRACT

After a successful kidney transplantation, renal and endocrine functions quickly return to normal in many women and ovulation ensues. Woman with a renal transplant can have a successful pregnancy, however, there are many risks for both the mother and the fetus. For this reason, these patients should be carefully monitored with a multidisciplinary approach including a nephrologist and an obstetrician. Counseling about contraception and pregnancy after transplant should be initiated during the pretransplant evaluation process. The live birth rate appears comparable to the general population. Pregnancy timing depends on whether the graft function is optimal, but the general recommendation is to wait a year after transplantation. The recommended maintenance immunosuppressive therapy in pregnant women includes the use of calcineurin inhibitors (preferably tacrolimus), azathioprine, and low dose prednisone. Vaginal delivery should be preferred in kidney transplant patients. Cesarean section may be considered only when there is an absolute indication. Kidney transplant patients can breastfeed their children with appropriate drug combinations after birth; patients should be encouraged in this regard.