A second delivery after heart transplantation – a case study

Abstract

Pregnancy after organ transplantation is becoming relatively common. We present the case of a heart transplant recipient who gave birth to a second child. Despite the fact that the transplanted heart seems to adapt well to the changes caused by pregnancy, gestation in patients after heart transplantation may be complicated by hypertension, pre-eclampsia, or preterm labor. In this article, we consider the issues of preterm uterine contractions, anemia, thrombocytopenia, and several other complications in pregnant patients with transplanted hearts. We also present current opinions regarding the use of glucocorticoids as a form of preventing breathing disorders in neonates as well as breast-feeding by mothers receiving immunosuppressive agents. Pregnancies in heart transplant recipients should be considered high-risk. A second successful delivery of a healthy child remains a challenge for such patients and their doctors.

Successful Pregnancy after a Heart Transplant in Iran: A Case Report

“…Post-heart transplant pregnancy has been performed safely in selected patients. 8 , 9 According to the ISHLT guidelines, a multidisciplinary approach to reproductive health after a heart transplant should be considered. 10 Maternal comorbidities in the heart transplant population underscore the importance of a multidisciplinary approach to counseling and management.…”

“…Pregnancy management in women after vital organ transplant is mostly based on expert recommendations, and there are no guidelines based on randomized controlled trials. 9 , 12 Heart transplant women can give birth to healthy children through natural childbirth and Cesarean section. However, heart transplant recipients have been advised to avoid pregnancy in the first year after transplant, when the risk of rejection is higher and immunosuppressive therapy is the most aggressive.…”

“… 7 Such pregnancies are considered high-risk because they are associated with the risk of several common complications, including preeclampsia, spontaneous abortion, low birth weight, and intrauterine growth restriction. 8 , 9 …”

Anesthesia management for cesarean section 10 years after heart transplantation: a case report

“…If pre-pregnancy cardiac function is normal, the transplanted heart is generally able to adjust to these demands (Wu et al 2007 ). In reported cases of pregnancies following heart transplantation, outcomes of pregnancy have been good with no recurrence of cardiac dysfunction in the transplanted heart (Armenti et al 2008 ; Humphreys et al 2012 ; Kalinka et al 2014 ). However, the incidence of maternal complications is increased in heart transplant recipients (Miniero et al 2004 ; Sibanda et al 2007 ).…”

Successful Pregnancy and Delivery Following Two Heart Transplantations

“…Advances in the field of transplant over recent decades have improved survival outcomes for post cardiac transplant patients. Approximately one third of heart transplant recipients are women and of those, approximately 20% are of reproductive age [1,2]. Obstetric management of the post cardiac transplant patient is a complex clinical scenario with increasing incidence as these women continue to desire childbearing following surgery.…”