[Pregnancy after renal transplantation. Obstetrical follow up and long term outcome of the renal graft]. / La grossesse après transplantation rénale. Suivi obstétrical et retentissement à long terme sur le greffon rénal.

OBJECTIVES: To study the course of pregnancy after renal transplantation and to assess the impact of the pregnancy on the renal graft. MATERIAL AND METHODS: [corrected] Retrospective study of 20 pregnancies from 16 renal transplant recipients between January 1987 and December 1998. Mean patient age was 30.3 +/- 4 years. Mean time between transplantation and the onset of pregnancy was 56.4 +/- 34.8 months. RESULTS: The main maternal complications were hypertensive disorders (7 cases) of which 3 preeclampsia. The mean gestational age at delivery was 36 +/- 3.1 weeks. Ten patients delivered prematurely of which 9 were induced prematurity. Nine cesarean sections were carried out either for obstetrical reasons or for causes not directly related to the transplantation. The mean neonatal weight was 2386 +/- 644 g with five small for gestational age. We did not observe any acute rejection. The follow up revealed six cases of chronic rejection. None of them seemed directly related to the pregnancy. CONCLUSIONS: The course of pregnancy after renal transplantation is generally uncomplicated without increased risk of graft lose. However, a stable renal function and an interval of two years or more after the transplantation are requested before allowing a pregnancy. Hypertension, diabetes mellitus or impaired renal function (creatininemia > 150 mumol/l) are contraindications for pregnancy.

[Delivery logbook: pertinence of the collected data for scientific exploitation]. / Le cahier d'accouchement: pertinence du recueil des données pour l'exploitation scientifique.

OBJECTIVES: To determine if the data recorded in the delivery logbook are relevant and complete compared to the data registered in the patient's medical chart. MATERIAL AND METHODS: Prospective study during one month recording all the data registered by the midwives or the medical doctors in the delivery room immediately after the birth. To compare them to the information collected in the patient's medical chart. Our delivery logbook has 55 headings for each patient. During October 1998, we had 156 births. RESULTS: We had 5.3% of errors divided by missing data and erroneous entries. More precisely, we recorded 9.5% of errors in the antepartum data, 3.2% in intrapartum or postpartum events and 5.8% in the newborn information. CONCLUSION: This study demonstrates that medical data used for scientific projects and recorded in the delivery logbook, have to be interpreted very cautiously. It seems to be reasonable that each obstetrical unit should standardize its registration of data and carry out internal audits.