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ObjectiveTo evaluate the pregnancy outcomes in female kidney transplant recipients and the long-term follow-up for the health of the offspring. MethodsClinical data from April 1978 to April 2011 of 15 female renal transplant recipients who were pregnant more than 5 months and their offspring were retrospectively analyzed. ResultsThe 15 recipients were taking CsA or Tac based immunosuppressive regimens.Twelve had successful pregnancies with stable and functioning grafts ; 1 paitent died of pulmonary infection and cardiac failure with functioning graft after the delivery of a healthy male infant; 2 experienced chronic rejection proven by biopsy at week 21 and 23 respectively,the pregnancies were therefore terminated and the grafts were lost even after rescue.All 13 newborns were smoothly delivered by cesarean section,they had an average gestational age of 35.2 ± 4.0 weeks,and a mean birth weight of 2510 ± 68 g,Apgar scale for each infant was 10,respectively.There were no birth defects,structural malformations,nor learning disabilities in 13 newborns,and their mothers all chose to bottle-feed.Thirteen children had normal intelligence,physical and mental development.Seven children experienced repeated respiratory tract infections during 0- 2 years,and 1 was diagnosed with attention deficit hyperactivity disorder.The oldest offspring is 21 years old and the youngest is 3 years old. ConclusionsFemale renal kidney recipients could achieve successful pregnancies and deliveries 3 years post transplantation with strict criteria.Their offspring were healthy during follow-up.
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Objective To investigate the influence of pregnancy on graft after renal transplantation. Methods Clinic data from 13 female transplant recipients with pregnant duration more than 5 months from May 1978 to March 2002 were retrospectively analyzed. Results Immunosuppressive programs: 4 patients received CsA plus Pred, 5 CsA, MMF plus Pred, and 4 FK506, MMF plus Pred. Among the 13 cases, 10 had successful pregnancies with stable graft function; one died of pulmonary infection and cardiac insufficiency with functioning graft after delivery (the baby was safe); 2 experienced chronic rejection proven by biopsy, getting graft lost and pregnancy terminated: one returned to hemodialysis till now and one received successful retransplantation after 1 year hemodialysis. 11 offerings are healthy by now.Conclusion Patient/kidney survival in our study was 76.9?% . Our data and literature have demonstrated that pregnancy has no effect on graft long term survival or function. It is advisable in a woman of childbearing age with a well functioning renal graft 2 years after transplantation, but must be considered risk. Chronic rejection is a risk factor for graft loss following pregnancy. FK506,CsA and MMF have no side effect on newborns.
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Objective To study the diagnosis and treatment of ureteral obstruction caused by endometriosis. Methods Out of 23 patients suffered from endometriosis treated from 1997 to 2000,ureteral obstruction occurred in 2 accompanied by hydronephrosis and dilatation of ureter.Both the 2 underwent sub total hysterectomy, resection of the intumescence in pelvic cavity, and the ureter was freed from the surrounding tissue. Results Ureteral obstruction was relieved in 7～10 days after the procedure. Both the petients were followed up for 2 years without recurrence. Conclusions Attention shoud be called to ureteral obstruction caused by endometriosis.Ultrasonic examination and intravenous pyelogram before operation, close examination of the ureter and adequate freeing of the ureter from it's surrounding tissue during operation, the application of gestrinone for 6 months after the operation, and scheduled following up would yield a satisfactory outcome.
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In order to evaluate the pathogenisis, definite the position and mechanism of ovarian dysfunction. Methods Pi-tuitarygonadal hormones ,-.P and prolactin (PRL) were measured in 25 premenopausal hemodialysis women using enzyme im-munoassay (E3A). Results Patients' serum PRL levels significantly elevated, FSFKLH levels also elevated, whereas P levels were obviously lower compared with normal women. Conclusion (1) Hypothalamic-pituitary-ovarian axis was impaired in uremia women as indicated by the prevalence of acydicity and the failure of LH,E2 levels and marked low P levels. (2)In uremia women clomiphenum stimulation test was positive suggested that the pituitary-ovarian axis were normal, whereas hypothalamic was impaired. (3) Hyperprolactinemia, owing to increased pituitary prolactin secretion. Suppression with bromocriptine was unstable. (4) During dialysis, symptom treating is suitable rather than trigger the ovalation. Successful renal transplantation is the best treatment.