Cardiac transplantationPregnancy outcomes in female heart and heart-lung transplant recipients
Section snippets
Materials and methods
Female heart and heart-lung recipients were identified by their physicians, transplant coordinators, or self-reported to the registry. Data were collected via a single-page questionnaire completed by the recipient, with follow-up information obtained from telephone interviews and hospital records.
Results
There were 29 recipients (26 heart and 3 heart-lung) who reported 50 pregnancies. Maternal factors and pregnancy outcomes are summarized in Table 1. Of note, 48% of the women were hypertensive during their pregnancies. Live births resulted from 70% of the pregnancies, 13% of the pregnancies were complicated by preeclampsia, and 40% of the live births were premature (<37 weeks gestation). Rejection during pregnancy occurred in 10 heart recipients. Treatment for rejection was steroid-based in 6
Discussion
Favorable outcomes following pregnancy in female heart and heart-lung transplant recipients are possible. However, pregnancies in these recipients are considered high risk because of maternal hypertension and the increased risk of preeclampsia and pre-term labor.2 The impact of these factors on maternal graft function and pregnancy outcomes is currently unknown.
Cyclosporine-based regimens predominated in this series. There were 4 recipients who reported 4 pregnancies while maintained on
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