Successful pregnancy and delivery in a patient on maintenance hemodialysis and in two patients after kidney transplantation

We report 3 cases of successful pregnancy and delivery in chronic renal failure patients. One patient had been undergoing chronic hemodialysis, the others were being followed after kidney transplantation. Case 1: A 31-year-old woman had been undergoing hemodialysis since 1979. In November 1987, she was found to have a pregnancy of 8 gestational weeks. She delivered a boy weighing 1, 625g by the vaginal route at 31 gestational weeks. He suffered imperforate anus. Case 2: A 39-year-old woman had been undergoing hemodialysis since 1985. In August 1989, she received a kidney from her father. In August 1992, she was found to have a pregnancy of 7 gestational weeks. She delivered a boy weighing 2, 275g by caesarean section at 38 gestational weeks. No congenital malformation was detected in the newborn. In this case, her husband had also been well controlled following kidney transplantation from a living related donor in 1985. Case 3: A 28-year-old woman had been undergoing hemodialysis since 1988. In June 1992, she received a kidney from her brother. In December 1993, she was found to have a pregnancy of 5 gestational weeks. She delivered a boy weighing 2, 620g by caesarean section at 41 gestational weeks. No congenital malformation was detected in the newborn. In this case, the ciclosporin (CYA) concentrations in maternal and neonatal whole blood samples, breast milk and amniotic fluid were determined by radioimmunoassay (RIA). No side effects of CYA were observed in this baby. CYA, however, was present in maternal breast milk, suggesting that breast-feeding by CYA-treated mothers should be avoided.