Pregnancy in women known to be living with a single kidney

Steele, Samantha; Terry, Jayne; Page, L. Le; Girling, Joanna

doi:10.1177/1753495x18784081

Cited by 12 publications

(11 citation statements)

References 23 publications

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“…All three women had unilateral renal agenesis. Although one woman with unilateral renal agenesis did not develop pre‐eclampsia, the 75% risk of pre‐eclampsia in women with single kidneys following UTx is higher than the previously reported 35% risk . It could be argued that this may be a consequence of other factors associated with UTx, such as in vitro fertilisation, embryo cryopreservation, immunosuppression, or the transplant of postmenopausal, less elastic uteri .…”

Section: Obstetric Outcomesmentioning

confidence: 73%

Human uterine transplantation: a review of outcomes from the first 45 cases

Jones

Saso

Bracewell‐Milnes

et al. 2019

BJOG

138

195

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Uterine transplantation restores reproductive anatomy in women with absolute uterine factor infertility and allows the opportunity to conceive, experience gestation, and acquire motherhood. The number of cases being performed is increasing exponentially, with detailed outcomes from 45 cases, including nine live births, now available. In light of the data presented herein, including detailed surgical, immunosuppressive and obstetric outcomes, the feasibility of uterine transplantation is now difficult to refute. However, it is associated with significant risk with more than one-quarter of grafts removed because of complications, and one in ten donors suffering complications requiring surgical repair.Tweetable abstract Uterine transplantation is feasible in women with uterine factor infertility, but is associated with significant risk of complication.

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Section: Obstetric Outcomesmentioning

confidence: 73%

Human uterine transplantation: a review of outcomes from the first 45 cases

Jones

Saso

Bracewell‐Milnes

et al. 2019

BJOG

138

195

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“…Of the 93 articles identified, 66 were excluded based on the initial title/abstract screening, leaving 27 for full screening; 16 articles were included in the systematic review (Figure 1 ). 11 , 12 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 These were published over 35 years (1985–2020), from eight countries (Table 1 ). Four case studies/series were identified but not discussed further.…”

Section: Resultsmentioning

confidence: 99%

“…Four case studies/series were identified but not discussed further. 20 , 23 , 25 , 28 Risk‐of‐bias, varied from low 21 , 24 , 26 to moderate 12 , 22 , 30 to serious 17 , 18 , 19 (Figure 2 ). Studies with a low risk of bias were broadly consistent in the direction of their findings.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 93 articles identified, 66 were excluded based on the initial title/abstract screening, leaving 27 for full screening; 16 articles were included in the systematic review (Figure 1). 11,12,17–30 These were published over 35 years (1985–2020), from eight countries (Table 1). Four case studies/series were identified but not discussed further 20,23,25,28 .…”

Section: Resultsmentioning

confidence: 99%

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Pregnancy after living kidney donation, a systematic review of the available evidence, and a review of the current guidance

Pippias

Skinner

Noordzij

et al. 2022

American Journal of Transplantation

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Understanding and communicating the risk of pregnancy complications post‐living kidney donation is imperative as the majority of living kidney donors (LKD) are women of childbearing age. We aimed to identify all original research articles examining complications in post‐donation pregnancies and compared the quality and consistency of related guidelines. We searched Embase, MEDLINE, PubMed, society webpages, and guideline registries for English‐language publications published up until December 18, 2020. Ninety‐three articles were screened from which 16 studies were identified, with a total of 1399 post‐donation pregnancies. The outcome of interest, post‐donation pregnancy complications, was not calculable, and only a narrative synthesis of the evidence was possible. The absolute risk of pre‐eclampsia increased from ~1%–3% pre‐donation (lower than the general population) to ~4%–10% post‐donation (comparable to the general population). The risks of adverse fetal and neonatal outcomes were no different between post‐donation and pre‐donation pregnancies. Guidelines and consensus statements were consistent in stating the need to inform LKDs of their post‐donation pregnancy risk, however, the depth and scope of this guidance were variable. While the absolute risk of pregnancy complications remains low post‐donation, a concerted effort is required to better identify and individualize risk in these women, such that consent to donation is truly informed.

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“…Among them, urinary tract infection complicated 50% of pregnancies and 35% developed pre-eclampsia during course of their pregnancy. 40 We studied 5 out of 13 (38%) cases having pre-diagnosed solitary kidney. Of these 20% were known renal hypertensive and consequently developed superimposed preeclampsia and 20% suffered from symptomatic UTI (E. coli>105CFU).…”

Section: Discussionmentioning

confidence: 99%

Chronic kidney disease in pregnancy and fetomaternal outcome

Gupta

Chawla

Ara

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Chronic kidney disease is a heterogeneous group of renal dysfunctions with complex and varied presentations in pregnancy. With a long asymptomatic course, timely diagnosis and management is crucial for fetomaternal wellbeing.Methods: A retrospective cohort study over a period of 3 years and 4 months included all obstetric in patients with known or newly diagnosed renal disorders. Maternal outcome was measured with regard to biochemical parameters presence /absence of proteinuria, hypertension, mode of pregnancy termination and complications. Fetal outcome was noted with respect to antenatal complications, weight, Apgar, NICU stay. Computation of results was done using percentages, mean and proportions.Results: Out of 13 women studied, 53.8% were pre-diagnosed cases of renal dysfunction and 46.2% were diagnosed during pregnancy. 38% had proteinuria at first visit and 50% remained so even after delivery. 60% had history of pregnancy induced hypertension in their previous pregnancies. Secondary hypertension and superimposed preeclampsia were seen in 30% and 38% cases respectively, with only one patient requiring magnesium sulphate prophylaxis in post-partum. Cardiac dysfunction was found to be coexisting in 15.3% cases with pre-existing renal leision. Intrauterine growth restriction was seen in 61.5% cases Average fetal weight was 2. 26kg with 30% having NICU stay. 30.6% had preterm delivery. Mode of delivery was caesarean section in 46% cases.Conclusions: Pregnancy with CKD is a high-risk pregnancy with adverse fetomaternal outcomes. For optimal pregnancy outcomes, an expert multidisciplinary team is required. With limited studies in south Asian population, there needs to be an upgradation in registry system.

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Pregnancy in women known to be living with a single kidney

Cited by 12 publications

References 23 publications

Human uterine transplantation: a review of outcomes from the first 45 cases

Human uterine transplantation: a review of outcomes from the first 45 cases

Pregnancy after living kidney donation, a systematic review of the available evidence, and a review of the current guidance

Chronic kidney disease in pregnancy and fetomaternal outcome

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