Karima Boubaker^1,, Ezzedine Abderrahim¹, Taieb Ben Abdallah¹, Adel Kheder¹

Fertility is considerably affected in chronic renal insufficiency and periodic hemodialysis and is improved by renal transplantation. Transplanted patients recover from their renal failure state and, pregnancy occurred in 2% in renal graft recipients in age to procreate. The aim of our study is to bring back the cases of pregnancies carried out in our renal patients transplanted and to specify the possible complications of the foetus and the mother schools to the course or after the childbirth. It is a retrospective study over one 20 years period of 1986 to 2006 of 10 pregnancies occurred in 7 renal transplant recipients followed in our Charles Nicole hospital department. Mean patient age was 33,8 years (29- 43 years). Mean time between transplantation and the onset of pregnancy was 6.5 years (1-18 years). Before pregnancy, hypertension was observed in 1 case and proteinuria in other case. All our patients had creatininemia<1,50mg /dl. Immunosuppressive treatment associated steroids and azathioprin in 3 cases, steroids and ciclosporin A in 2 cases and steroids, ciclosporin A and azathioprin in 2 cases. One patient developed diabetes. Maternal complications were rare, essentially hypertension in 2 cases, proteinuria in 1 case, ascension of creatininemia in 2 cases and hepatic cholestase in 2 cases. Deliverance was at time in 8 cases. Prematurity was observed in 2 cases; it was related to premature rupture of membranous in 1 case and uterine contractions in cesarean patient in other case. The mean neonatal weight was 2950 g (2100- 3500 g) with 4 small for gestational age (< 2800 g). It was noted 1 case of newborn down's syndrome in a pregnant women aged of 37 years. After a mean follow up of 7,4 years follow-up, mean cretininemia was 1,80mg /dl (0,74-5,53mg /dl). One patient showed chronic rejection. Immunosuppressive treatment seemed without adverse effects on fetus. The only case of chromosome abnormality was appeared in a pregnant women aged more than 35 years. The course of pregnancy after renal transplantation is generally uncomplicated without increased risk of graft loses. However, a normal arterial pressure, a stable renal function and absence of proteinuria are requested before allowing a pregnancy.