In most women with a kidney transplant, fertility is spontaneously restored within a few months (1). This offers the chance for transplanted women to experience parenthood. Pregnancy is feasible for women with a kidney transplant and increasingly a more common reality (2). However, these pregnancies remain complex and high risk - often complicated by preterm delivery, pregnancy-induced hypertension, preeclampsia, caesarean delivery, miscarriage and gestational diabetes (2,3). Babies born to women with kidney transplantation are also significantly affected, with twice the odds of adverse outcomes compared to babies not born to women on kidney replacement therapy (3). With advancements in obstetric and multidisciplinary care, outcomes continue to improve. However, navigating safer pathways to pregnancy for women with kidney transplantation remains key and is an important skill for health care providers.
In this session, we present the South Australian-Northern Territory Protocol for Preconception and Pregnancy Management in Women with Kidney Transplantation - discussing the main potential issues of pregnancy in kidney transplantation. The session will focus on: preconception counselling, maternal medical management during pregnancy and choice of immunosuppressive agents.
This protocol was formulated by a South Australian writing and consumer group who have clinical and research experience in obstetric nephrology.