Ishod trudnoće kod bolesnice sa transplantiranim bubregom: prikaz slučaja i pregled literature

  • Andreja Glišić University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Clinic for Gynecology and Obstetrics,Belgrade, Serbia
  • Nevena Divac University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Institute of Pharmacology, Clinical Pharmacology and Toxicology, Belgrade, Serbia
  • Miroslava Gojnić Dugalić University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Clinic for Gynecology and Obstetrics,Belgrade, Serbia
  • Biljana Kastratović Kotlica University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Clinic for Gynecology and Obstetrics,Belgrade, Serbia
  • Neven Vavić Military Medical Academy, Center for Transplantation of Solid Organs, Belgrade, Serbia
  • Nataša Cerovac Military Medical Academy, Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
  • Milica Prostran University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Institute of Pharmacology, Clinical Pharmacology and Toxicology, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP151208196G
Ključne reči: kidney transplantation||, ||transplantacija bubrega, pregnancy||, ||trudnoća, fetal development||, razvoj fetusa, tacrolimus||, ||takrolimus, azathioprine||, ||azatioprin, prednisolone||, ||prednizolon,

Sažetak


Uvod. Mogućnost uspešne trudnoće kod žena sa presađenim bubregom smatra se jednim od najvećih uspeha ove vrste lečenja, ali nosi sa sobom i određene probleme u vezi sa bezbednošću majke, fetusa i presađenog organa. Upotreba imunosupresivne terapije tokom trudnoće povezana je sa mnogim neželjenim efektima. Prikaz slučaja. Prikazali smo bolesnicu sa presađenim bubregom koja je tokom trudnoće primala imunosupresivnu terapiju (takrolimus, azatioprin i prednizolon). Ishod trudnoće je bio uspešan i po majku i po novorođenče.  Nivo serumskog kreatinina majke bio je stabilan sve vreme trudnoće i nije doslo do akutnog odbacivanja presađenog organa. Tokom trećeg trimestra došlo je do neuobičajenog porasta D-dimera i faktora koagulacije II, VII, IX i X, što je retka, ali moguća komplikacija primene azatioprina. Nije bilo kliničkih niti radioloških znakova tromboembolizma, ali je niskomolekularni heparin uveden profilaktički. Trudnoća je završena u 39-oj nedelji gestacije planiranim carskim rezom i rođeno je zdravo žensko dete porođajne težine 3 150 g, ocenjeno Apgar skorom 9. Zaključak. Trudnoća kod bolesnice sa presađenim bubregom smatra se visoko rizičnom i zahteva pažljivo planiranje i praćenje.

 

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Objavljeno
2017/09/19
Broj časopisa
Vol. 74 Br. 8 (2017)
Rubrika
Prikaz bolesnika