Pregnancy Counseling for Kidney Transplant Recipients
2020
Given the possible medical complications, risks, and the need for informed decision making, pregnancy after kidney
transplantation is a serious and difficult issue. In this article, we summarize aspects related to pregnancy counselling
for kidney transplant recipients based on past research.
Kidney transplant recipients tend to have overall higher rates of preterm deliveries, low-birthweight babies, and
caesarean section than the general population. There have been instances of maternal complications such as
preeclampsia, allograft loss, and urinary tract infections during pregnancy; in particular, hypertension is a common
problem among kidney transplant recipients.
Pregnancy counselling should start when a recipient chooses renal replacement therapy, and the counselling program
should be tailored to the recipient's life cycle and treatment period. It is necessary to explain the essential conditions
for pregnancy, such as the need to change to a safe drug, ensure stable kidney function, and wait one to two years
after transplantation before conception. Medical staff should be informed about menstrual recovery after
transplantation, contraception, and unexpected pregnancy. When a recipient becomes pregnant, it is necessary to
convey information about the mode of delivery and breastfeeding.
The contents of pregnancy counselling must be modified according to recipient needs, and detailed discussions are
needed between medical staff and transplant recipients. Medical staff should support recipients and their family
during the decision-making process before conception. It is essential for kidney transplant recipients to discuss the
topic of pregnancy with transplantation physicians, so as to give birth safely and maintain their health with a donated
kidney.
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