BackgroundReproductive function in women with end stage renal disease generally improves after kidney transplant. However, pregnancy remains challenging due to the risk of adverse clinical outcomes.MethodsWe searched PubMed/MEDLINE, Elsevier EMBASE, Scopus, BIOSIS Previews, ISI Science Citation Index Expanded, and the Cochrane Central Register of Controlled Trials from date of inception through August 2017 for studies reporting pregnancy with kidney transplant.ResultsOf 1343 unique studies, 87 met inclusion criteria, representing 6712 pregnancies in 4174 kidney transplant recipients. Mean maternal age was 29.6 ± 2.4 years. The live-birth rate was 72.9% (95% CI, 70.0–75.6). The rate of other pregnancy outcomes was as follows: induced abortions (12.4%; 95% CI, 10.4–14.7), miscarriages (15.4%; 95% CI, 13.8–17.2), stillbirths (5.1%; 95% CI, 4.0–6.5), ectopic pregnancies (2.4%; 95% CI, 1.5–3.7), preeclampsia (21.5%; 95% CI, 18.5–24.9), gestational diabetes (5.7%; 95% CI, 3.7–8.9), pregnancy induced hypertension (24.1%; 95% CI, 18.1–31.5), cesarean section (62.6, 95% CI 57.6–67.3), and preterm delivery was 43.1% (95% CI, 38.7–47.6). Mean gestational age was 34.9 weeks, and mean birth weight was 2470 g. The 2–3-year interval following kidney transplant had higher neonatal mortality, and lower rates of live births as compared to > 3 year, and < 2-year interval. The rate of spontaneous abortion was higher in women with mean maternal age < 25 years and > 35 years as compared to women aged 25–34 years.ConclusionAlthough the outcome of live births is favorable, the risks of maternal and fetal complications are high in kidney transplant recipients and should be considered in patient counseling and clinical decision making.Electronic supplementary materialThe online version of this article (10.1186/s12882-019-1213-5) contains supplementary material, which is available to authorized users.

Abstract:We analyzed 27 established and new simple and therefore perhaps portable satellite phycocyanin pigment reflectance algorithms for estimating cyanobacterial values in a temperate 8.9 km 2 reservoir in southwest Ohio using coincident hyperspectral aircraft imagery and dense coincident water surface observations collected from 44 sites within 1 h of image acquisition. The algorithms were adapted to real Compact Airborne Spectrographic Imager (CASI), synthetic WorldView-2, Sentinel-2, Landsat-8, MODIS and Sentinel-3/MERIS/OLCI imagery resulting in 184 variants and corresponding image products. Image products were compared to the cyanobacterial coincident surface observation measurements to identify groups of promising algorithms for operational algal bloom monitoring. Several of the algorithms were found useful for estimating phycocyanin values with each sensor type except MODIS in this small lake. In situ phycocyanin measurements correlated strongly (r 2 = 0.757) with cyanobacterial sum of total biovolume (CSTB) allowing us to estimate both phycocyanin values and CSTB for all of the satellites considered except MODIS in this situation.

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This study evaluated the performances of twenty-nine algorithms that use satellite-based spectral imager data to derive estimates of chlorophyll-a concentrations that, in turn, can be used as an indicator of the general status of algal cell densities and the potential for a harmful algal bloom (HAB). The performance assessment was based on making relative comparisons between two temperate inland lakes: Harsha Lake (7.99 km) in Southwest Ohio and Taylorsville Lake (11.88 km) in central Kentucky. Of interest was identifying algorithm-imager combinations that had high correlation with coincident chlorophyll-a surface observations for both lakes, as this suggests portability for regional HAB monitoring. The spectral data utilized to estimate surface water chlorophyll-a concentrations were derived from the airborne Compact Airborne Spectral Imager (CASI) 1500 hyperspectral imager, that was then used to derive synthetic versions of currently operational satellite-based imagers using spatial resampling and spectral binning. The synthetic data mimics the configurations of spectral imagers on current satellites in earth's orbit including, WorldView-2/3, Sentinel-2, Landsat-8, Moderate-resolution Imaging Spectroradiometer (MODIS), and Medium Resolution Imaging Spectrometer (MERIS). High correlations were found between the direct measurement and the imagery-estimated chlorophyll-a concentrations at both lakes. The results determined that eleven out of the twenty-nine algorithms were considered portable, with r values greater than 0.5 for both lakes. Even though the two lakes are different in terms of background water quality, size and shape, with Taylorsville being generally less impaired, larger, but much narrower throughout, the results support the portability of utilizing a suite of certain algorithms across multiple sensors to detect potential algal blooms through the use of chlorophyll-a as a proxy. Furthermore, the strong performance of the Sentinel-2 algorithms is exceptionally promising, due to the recent launch of the second satellite in the constellation, which will provide higher temporal resolution for temperate inland water bodies. Additionally, scripts were written for the open-source statistical software R that automate much of the spectral data processing steps. This allows for the simultaneous consideration of numerous algorithms across multiple imagers over an expedited time frame for the near real-time monitoring required for detecting algal blooms and mitigating their adverse impacts.

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