Saudi Journal of Kidney Diseases and Transplantation

EDITORIAL
Year
: 2008  |  Volume : 19  |  Issue : 2  |  Page : 165--173

Pregnancy and Contraceptive Issues in Renal Transplant Recipients


Ayman Karkar 
 Kanoo Kidney Centre, Dammam Central Hospital, Dammam, Saudi Arabia

Correspondence Address:
Ayman Karkar
Department of Nephrology, Kanoo Kidney Centre, Dammam Central Hospital, P.O. Box 11825, Dammam 31463
Saudi Arabia

Fertility is improved within months and conception is achieved within one to six years after kidney transplantation. Pregnancy is safe and has little effect on long-term graft survival, but has increased maternal and fetal risks. Pregnancy is contraindicated in the first two years post-kidney transplantation due to increased risk of acute rejections and higher doses of immunosuppressive drugs. Poor renal function, uncontrolled diabetes mellitus and hypertension are other contraindications. Family planning and counseling, and consideration of a suitable contraceptive method are essential before transplantation. Tubal ligation and vasectomy are permanent contraceptives with the least failure results. Combined pills are highly effective and are among the lowest failure rate contraceptives, but they interact with cyclosporine, and are contraindicated in patients with thromboembolism and deep vein thrombosis. Progesterone-only minipill has the advantage of avoiding the risks associated with estrogen, but has a higher failure rate than the combined pills. The barrier methods (condom and diaphragm) are effective and safe contraceptives and can prevent sexually transmitted diseases, but require motivated couples. Intra uterine devices are convenient contraceptives, but have higher failure rate and are associated with increased incidence of pelvic infection. Pregnancy in renal transplant recipients should be managed by a multidisciplinary approach in a tertiary centre.


How to cite this article:
Karkar A. Pregnancy and Contraceptive Issues in Renal Transplant Recipients.Saudi J Kidney Dis Transpl 2008;19:165-173


How to cite this URL:
Karkar A. Pregnancy and Contraceptive Issues in Renal Transplant Recipients. Saudi J Kidney Dis Transpl [serial online] 2008 [cited 2019 Dec 12 ];19:165-173
Available from: http://www.sjkdt.org/article.asp?issn=1319-2442;year=2008;volume=19;issue=2;spage=165;epage=173;aulast=Karkar;type=0