Pregnancy in a patient with renal allograft, type 1 diabetes mellitus, and combined heart disease: Course complexities, therapy approaches


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Abstract

Ministry of Health of Russia, Moscow 129226, 1st Leonova str. 16, Russia 3Moscow Clinical Research Center, Moscow Healthcare Department, Moscow 111123, Enthusiasts shosse 86, Russia 4Academician V.I. Shumakov Research Center of Transplantology and Artificial Organs, Ministry of Health of Russia, Moscow 123182, Schukinskaya str. 1, Russia Background. Every case of successful pregnancy in women with renal allograft is of practical interest to specialists of different profiles. A case report. The paper describes a rare clinical observation of the course of pregnancy in a patient with a compromised somatic history of severe type 1 diabetes mellitus on insulin pump delivery with renal allograft, reduced function, grade 3 hypertension that is difficult to cure with triple therapy, and heart defect identified during pregnancy with moderate pulmonary hypertension. Conclusion. Our demonstrated case illustrates the difficulties the physicians of different profiles face when managing pregnancy in patients with extragenital diseases. The paper describes the characteristics of the course of pregnancy, as well as the possibility of a favorable outcome for the mother and her fetus, provided the teamwork of specialists of different profiles.

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About the authors

Tatiana V. Kirsanova

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

PhD Senior Researcher of the Therapeutic Department

N. F Kravchenko

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

PhD, Researcher of the 1st department of pathology of pregnancy

N. K Runikhina

Russian Gerontology Research and Clinical Center

MD, Deputy Director for scientific and medical work

G. A Elenshleger

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Doctor of functional diagnostics

R. M Esayan

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Head of the therapeutic department

L. V Koshel

Moscow Clinical Research Center

PhD, senior researcher

M. A Vinogradova

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

PhD, Head of the Division of Hematology and Clinical Reproductive Hemostasis

I. E Kandidova

Academician V.I. Shumakov Research Center of Transplantation and Artificial Organs, Ministry of Health of Russia

Honoured Doctor of Russia, PhD, Leading the Department of Nephrology Kidney and liver transplantation

References

  1. Levidiotis V., Chang S., McDonald S. Pregnancy and maternal outcomes among kidney transplant recipients. J. Am. Soc. Nephrol. 2009; 20(11): 2433-40.
  2. McKay D.B., Josephson M.A. Pregnancy in recipients of solid organs - effects on mother and child. N. Engl. J. Med. 2006; 354(12): 1281-93.
  3. Кулаков В.И., Мурашко Л.Е., Мойсюк Я.Г. и др. Беременность и роды у женщин с пересаженной почкой. Акушерство и гинекология. 2004; 2: 27-32. [Kulakov V.I., Murashko L.E., Moisyuk Ya.G. Pregnancy and childbirth in women with a transplanted kidney. Akusherstvo i ginekologiya/Obstetrics and gynecology. 2004; (2): 27-32. (in Russian)]
  4. Cyganek A., Wiczyhska-Zajac A., Jabiry-Zieniewicz Z., Marianowski L. Pregnancy delivery and newborn in female kidney recipients. Ginekol. Pol. 2001; 72(12A): 1287-90.
  5. Levidiotis V., Chang S., McDonald S. Pregnancy and maternal outcomes among kidney transplant recipients. J. Am. Soc. Nephrol. 2009; 20(11): 2433-40.
  6. Piccoli G.B., Fassio F., Attini R., Parisi S., Biolcati M., Ferraresi M. et al. Pregnancy in CKD: whom should we follow and why? Nephrol. Dial. Transplant. 2012; 27(Suppl. 3): iii111-8.
  7. Piccoli G.B., Attini R., Vasario E., Conijn A., Biolcati M., D’Amico F. et al. Pregnancy and chronic kidney disease: a challenge in all CKD stages. Clin. J. Am. Soc. Nephrol. 2010; 5(5): 844-55.
  8. Williams D., Davison J. Chronic kidney disease in pregnancy. BMJ. 2008; 336(7637): 211-5.
  9. De Vivo A., Baviera G., Giordano D., Todarello G., Corrado F., D’anna R. Endoglin, PlGF and SFLT-1 as markers for predicting pre-eclampsia. Acta Obstet. Gynecol. Scand. 2008; 87(8): 837-42.
  10. Lam C., Lim K.-H., Karumanchi S.A. Circulating angiogenic factors in the pathogenesis and prediction of preeclampsia. Hypertension. 2005; 46(5): 1077-85.
  11. Levine R., Maynard S., Qian C., Lim K., England H. Circulating angiogenic factors and the risk of preeclampsia. N. Engl. J. Med. 2004; 350(7): 672-83.
  12. Козловская Н.Л., Меркушева Л.И., Кирсанова Т.В., Бобкова И.Н., Боброва Л.А., Рунихина Н.К. Влияние дисбаланса плацентарных факторов ангиогенеза на клинические проявления «ранней» и «своевременной» преэклампсии. Нефрология и диализ. 2013; 15(3): 206-15
  13. Day C., Hewins P., Hildebrand S., Sheikh L., Taylor G., Kilby M. The role of renal biopsy in women with kidney disease identified in pregnancy. Nephrol. Dial. Transplant. 2008; 23(1): 201-6.
  14. Lessan-Pezeshki M. Pregnancy after renal transplantation: points to consider. Nephrol. Dial. Transplant. 2002; 17(5): 703-7.
  15. Богданов М.Б., Черненькая Т.В. Алгоритмы и организация антибиотикотерапии. М.: Издательский дом Видар М; 2004. 223с. [Bogdanov M.B., Chernenkaya TV Algorithms and organization of antibiotic therapy. Moscow: Publishing house Vidar M; 2004. 223cp. (in Russian)]
  16. Darby C.R., Roy D., Deardon D., Cornall A. Depopulated bovine ureteric xenograft for complex haemodialysis vascular access. Eur. J. Vasc. Endovasc. Surg. 2006; 31(2): 181-6.
  17. Davidson I. Access for dialysis: Surgical and radiologic procedures. Austin, USA: RG Landes Company; 2006.
  18. Montreuil B., Morrison R., Rosenberg L., Nohr C. Vascular and peritoneal access. In: ACS Surgery. Wilmore D.W., Cheung L.Y., Harken A.H., Holcroft J.W., Meakins J.L., eds. ACS Surgery. New York: WebMD; 2002; 897-919.
  19. Saxena A.K., Panhotra B.R. Haemodialysis catheter-related bloodstream infections: current treatment options and strategies for prevention. Swiss Med. Wkly. 2005; 135: 127-38
  20. Евсеев М.А., Исмаилов Н.Б., Козлов Д.В., Байков Б.В. Гнойно-септические осложнения при постоянном сосудистом доступе у больных, находящихся на программном гемодиализе. Хирургия. Журнал им. Н.И. Петрова. 2009; 6: 30-3. [Evseev M.A., Ismailov N.B., Kozlov D.V., Baikov B.V Purulent-septic complications with constant vascular access in patients on programmed hemodialysis. Surgery. N.I. Petrov Journal. 2009; 6: 30-3. (in Russian)]

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