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The risk of obstetrical syndromes after solid organ transplantation
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Brosens, Ivo, Brosens, Jan J. and Benagiano, Giuseppe (2014) The risk of obstetrical syndromes after solid organ transplantation. Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 28 (Number 8). pp. 1211-1221. doi:10.1016/j.bpobgyn.2014.08.001 ISSN 1521-6934.
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Official URL: http://dx.doi.org/10.1016/j.bpobgyn.2014.08.001
Abstract
Pregnancy after solid organ transplantation is perfectly possible, but it is associated with an increased risk of major obstetrical complications including pre-eclampsia, foetal growth restriction and preterm birth.
Following liver and kidney grafting, the risk of complications is higher especially after kidney transplant, reflecting pre-existing hypertensive and vascular disease. In these patients, prevention should start before the onset of pregnancy through normalisation of hypertensive and vascular conditions.
Following heart and lung transplants, the risk of rejection during and after pregnancy remains significant and an adequate immunosuppression is imperative, especially after lung transplants because of their intrinsic high rate of rejection.
A likely explanation for the higher risk of pregnancy complication is an alteration of the ‘placental bed’, the decidua and the inner myometrium underlying the placenta, a zone encompassing the full length of the spiral arteries supplying maternal blood to the placenta. Unfortunately, this zone has not been investigated in pregnancy after solid organ transplantation.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Reproductive Health ( - until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Best Practice & Research Clinical Obstetrics & Gynaecology | ||||||
| Publisher: | Elsevier Science Ltd. | ||||||
| ISSN: | 1521-6934 | ||||||
| Official Date: | November 2014 | ||||||
| Dates: |
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| Volume: | Volume 28 | ||||||
| Number: | Number 8 | ||||||
| Page Range: | pp. 1211-1221 | ||||||
| DOI: | 10.1016/j.bpobgyn.2014.08.001 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access |
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