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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Reference
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