20 June 2017 : Original article
Fetal Hypotrophy Is an Important Marker in Diagnosis of Preeclampsia in Pregnant Patients After Solid Organ TransplantationAnna Cyganek1ABCDE, Bronisława Pietrzak1AD, Filip A Dąbrowski1ABDEF*, Zoulikha Jabiry-Zieniewicz1E, Marcin Chlebus2CE, Mirosław Wielgos1DE, Barbara Grzechocińska1ADE
Ann Transplant 2017; 22:370-377
BACKGROUND: The purpose of this study was to use a multidisciplinary approach to define the importance of fetal growth disturbances in pregnant patients after renal or liver transplantation in diagnosis and treatment of preeclampsia.
MATERIAL AND METHODS: We assessed 108 pregnancies in patients with renal or liver transplants. Statistical analysis included Pearson’s chi-square test and Fisher’s exact test.
RESULTS: In the renal transplant (RTR) group, preeclampsia was diagnosed in 40% according to ISSHP. In the liver transplant (LTR) group, ISSHP guidelines allow this diagnose in 14.6% of patients. Intrauterine fetal hypotrophy occurred in 53.3% of RTR patients with clinical symptoms of preeclampsia and in none of stabile patients. Premature delivery rate was 40% in patients with hypotrophy and only in 15.5% without. For LTR patients, hypotrophy was diagnosed in 16.4% patients with clinical symptoms of preeclampsia and in 12.7% of stabile patients. Premature delivery rate was 14.5% in patients with hypotrophy and in 14.5% without.
CONCLUSIONS: Fetal hypotrophy is strongly associated with premature delivery and risk of preeclampsia in pregnancies after renal transplantation. There is a need for including ultrasound findings in diagnostic criteria of preeclampsia. Fetal growth monitoring may help in prediction of premature delivery in these group.
Keywords: Hypertension, Pregnancy-Induced, Kidney Transplantation, Liver Transplantation, Pre-Eclampsia, Pregnancy Complications
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