Delivery in pregnant women with the grafted kidney


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The authors describe their experience in managing pregnancy in 108 women with the grafted kidney, which ended in labor in 68 of them; cesarean section was made in 63 (92.7%) women. The surgery was performed through a transverse suprapubic access, with a transverse lower uterine segment incision. On extracting the fetal head, methylprednisolone was intravenously injected in a dose of 500-750 mg (bolus plus therapy) in order to prevent kidney graft rejection. Just after surgery, azathioprine was administered in a dose of 100 mg/day to enhance immunosuppression. In the postpartum period, antibacterial therapy was performed with second-third generation cephalosporins for 7-10 days. Sutures were removed on days 7-10 after surgery. Breastfeeding is contraindicated due to the fact that immunosuppressants can pass into breast milk.

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