Well managed, the great majority of pregnancies in kidney transplant recipients have apparently successful outcomes, although gestation and delivery are not necessarily complication-free, according to the results of a large international survey reported at the Second European Meeting on Renal Diseases in Milan. (These findings are fairly consistent with those of a much smaller Canadian study [Am J Obstet Gynecol 1983;145:193].)
An analysis of 1,068 pregnancies that occurred in 717 transplant recipients seen at 64 centers worldwide shows that after the first trimester, the success rate is 90%, stated John M. Davison, MB, of the Medical Research Council's Human Reproduction Group at Newcastle-upon-Tyne, England. He warned, however, that long-term effects of immunosuppressant drugs on the fetus are not known.
The first-trimester spontaneous abortion rate, 13%, was no higher than in the normal population. However, the incidence of therapeutic abortions in the same period was about 28%, Davison noted, commenting: "These