Intrauterine Growth Restriction in Pregnant Renal and Liver Transplant Recipients: Risk Factors Assessment

Cyganek, Anna; Pietrzak, Bronisława; Kociszewska-Najman, Bozena; Grzechocińska, Barbara; Songin, Tomasz; Foroncewicz, Bartosz; Mucha, Krzysztof; Wielgoś, Mirosław

doi:10.1016/j.transproceed.2014.09.001

Cited by 17 publications

(14 citation statements)

References 9 publications

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“…Cigarette, opiate, alcohol, and cocaine use cause fetal growth restriction directly and by decreasing maternal food intake (140,141). Even prescription medications like anticonvulsants, antineoplastic agents, and antithrombotic drugs are teratogens and can result in fetal growth restriction (142,143). Multifetal gestation and fetal malformations are also seen in association with intrauterine growth restriction.…”

Section: Current Understanding In Causes Of Iugrmentioning

confidence: 99%

Immunological Role of the Maternal Uterine Microbiome in Pregnancy: Pregnancies Pathologies and Alterated Microbiota

et al. 2020

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Understanding what happens at the time of embryo implantation has been the subject of significant research. Investigators from many differing fields including maternal fetal medicine, microbiology, genetics, reproductive endocrinology and immunology have all been studying the moment the embryo interacts with the maternal endometrium. A perfect relationship between the uterus and the embryo, mediated by a tightly controlled interaction between the embryo and the endometrium, is required for successful implantation. Any factors affecting this communication, such as altered microbiome may lead to poor reproductive outcomes. Current theories suggest that altered microbiota may trigger an inflammatory response in the endometrium that affects the success of embryo implantation, as inflammatory mediators are tightly regulated during the adhesion of the blastocyst to the epithelial endometrial wall. In this review, we will highlight the various microbiome found during the periconceptual period, the microbiomes interaction with immunological responses surrounding the time of implantation, its effect on implantation, placentation and ultimately maternal and neonatal outcomes.

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Section: Current Understanding In Causes Of Iugrmentioning

confidence: 99%

Immunological Role of the Maternal Uterine Microbiome in Pregnancy: Pregnancies Pathologies and Alterated Microbiota

et al. 2020

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“…This variance is likely due to inconsistent definitions of IUGR between studies. Certain studies have demonstrated that IUGR rates in LT recipients are statistically more frequent when compared with the general population …”

Section: Fetal Outcomesmentioning

confidence: 99%

“…The incidence of hypertension according to the type of immunosuppression is between 22% and 29% with corticosteroids, 63% and 73% with cyclosporine, and 47% and 54% with tacrolimus. (19,42,43,62,63) Cyclosporine may be related to higher rates of hypertension when compared with tacrolimus.…”

Section: Pregnancy-induced Hypertensionmentioning

confidence: 99%

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Pregnancy in Liver Transplantation

et al. 2020

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Pregnancy after liver transplantation (LT) is increasingly common and is a frequent scenario that transplant physicians, obstetricians, and midwives encounter. This review summarizes the key issues surrounding preconception, pregnancy‐related outcomes, immunosuppression, and breastfeeding in female LT recipients. Prepregnancy counseling in these patients should include recommendations to delay conception for at least 1‐2 years after LT and discussions about effective methods of contraception. Female LT recipients are generally recommended to continue immunosuppression during pregnancy to prevent allograft rejection; however, individual regimens may need to be altered. Although pregnancy outcomes are overall favorable, there is an increased risk of maternal and fetal complications. Pregnancy in this cohort remains high risk and should be managed vigilantly in a multidisciplinary setting. We aim to review the available evidence from national registries, population‐based studies, and case series and to provide recommendations for attending clinicians.

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“…The majority of preterm deliveries do not occur spontaneously but rather because of maternal and/or fetal compromise . Intrauterine growth restriction, defined as weight below the 10th percentile for gestational age, is also more common among pregnancies after transplantation, with an incidence as high as 31–50% compared with an incidence of 3–10% among the general obstetric population . These fetal complications may result in a variety of neurologic, developmental, cardiac, renal, and metabolic sequelae.…”

Section: Risks Of Pregnancy After Transplantationmentioning

confidence: 99%

Pharmacologic Considerations for Solid Organ Transplant Recipients Who Become Pregnant

Casale

Doligalski

2016

Pharmacotherapy

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Females of childbearing age represent a large population of solid organ transplant recipients. With fertility commonly restored after transplantation, the possibility of pregnancy becomes a reality for many patients. Since the first published report of a successful pregnancy after solid organ transplantation in 1963, the number of pregnancies reported for female organ recipients has continued to increase. Despite this, information on the management of immunosuppression during pregnancy is limited, and a summary of these data is lacking in the literature. In addition to the many pharmacotherapeutic challenges in this unique patient population, physiologic changes in the peripartum period significantly affect the pharmacokinetics and pharmacodynamics of commonly used immunosuppressive agents. These changes, as well as the adverse effects and safety concerns of medications, must all be taken in to consideration to optimize outcomes for both mother and baby. In this review, we provide clinicians caring for female solid organ transplant recipients who wish to become pregnant or who are currently pregnant with a comprehensive review of maternal and fetal risks of pregnancy after transplantation. In addition, pharmacokinetic and pharmacodynamic changes of pregnancy will be discussed, and a summary of data regarding optimal immunosuppression management during pregnancy will be presented.

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Intrauterine Growth Restriction in Pregnant Renal and Liver Transplant Recipients: Risk Factors Assessment

Cited by 17 publications

References 9 publications

Immunological Role of the Maternal Uterine Microbiome in Pregnancy: Pregnancies Pathologies and Alterated Microbiota

Immunological Role of the Maternal Uterine Microbiome in Pregnancy: Pregnancies Pathologies and Alterated Microbiota

Pregnancy in Liver Transplantation

Pharmacologic Considerations for Solid Organ Transplant Recipients Who Become Pregnant

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