Successful spontaneous pregnancy in a kidney graft recipient is regarded as a sign of full recovery. The crucial factors determining positive outcome are optimizing time of conception and multidisciplinary team care. However, there are only a few reports dealing with in vitro fertilization (IVF) outcomes in organ recipients. A 34-year-old living donor kidney recipient with primary infertility due to bilateral tubal obstruction was referred to our clinic. Transfer of 2 embryos was conducted after a long stimulation protocol with GnRH and rFSH, and a viable singleton pregnancy was confirmed by subsequent ultrasound examination. Pregnancy complications were: chronic hypertension, fetal intrauterine growth restriction, and severe anemia requiring blood transfusions and erythropoietin treatment. In the 34th week of gestation the patient presented with worsening of blood pressure control. A male newborn, 1810 grams weight and 10 points Apgar score was delivered by cesarean section. Although our patient was qualified for the IVF program with signs of suboptimal graft function, it was stable during the ovarian stimulation protocol. Fortunately, in the second half of the pregnancy only mild creatinine rise and proteinuria <1 g/day were observed. IVF may be a good treatment option in female kidney graft recipients. It does not necessarily lead to graft function deterioration and it provides multidisciplinary specialized care, allowing for delivery of a healthy newborn.

To determine and compare maternal, neonatal and graft outcomes in pregnant women after kidney or liver transplantation, who had delivered from 1 January 2005 to 1 February 2010. A retrospective, single-center study provided in Warsaw, Poland. Complete data were collected in 38 deliveries in 37 women. Preexisting hypertension was present in 15 of 19 (79%) pregnant kidney recipients and in 2 of 19 (10.5%) women after liver transplantation (p < 0.000). The incidence of preeclampsia was also more often in pregnant kidney recipients (p = 0.04). Mean gestational age at labor was lower in the kidney group (34.9 ± 3.56 vs. 37.5 ± 1.62, p = 0.000). A similar relation was observed in the frequency of preterm deliveries before 37 weeks of gestation (42% vs. 11%, respectively, p = 0.02) and neonates small for gestational age (47% vs. 11%, respectively, p = 0.008). Cesarean sections were performed in approximately 79% (15/19) and 95% (18/19) liver and kidney posttransplant pregnancies, respectively. Four of 38 infants presented structural malformations. Pregnancies after kidney transplantation are complicated with a higher prevalence of prematurity and worse neonatal prognosis, which depends mainly on the underlying condition.

Objective: The objective of this study was to investigate the composition of breast milk which had been gathered from mothers for over first 2 weeks of lactation and to compare the changes in composition of preterm and term milk. Methods: A prospective, single center study was provided in Warsaw, Poland. The samples of breast milk from 22 mothers who had delivered prematurely and 39 mothers who had given birth to term infants were collected. The creamatocrit, energy and fat concentration were estimated in each participant’s breast milk sample twice a day (morning and night hours). Results: The lowest creamatocrit, calories and fat concentration was indicated in the preterm milk obtained in the morning (4.86%, 663.8 kcal/L and 33.6 g/L, respectively). The highest milk parameters were observed in the night samples of full-term milk and measured (9.6%, 919.7 kcal/L, and 60.7 g/L, respectively). No significant differences in analysed parameters were observed between preterm and full-term milk (p > 0.05). In summary, creamatocrit, calories and lipid concentration in breast milk shows the daily differences. Colostrum and mature milk from mothers of preterm neonates differed from colostum and mature milk from mothers of term neonates. They had lipid contents, creamatocrit level and calorific value.

The influence of pregnancy on graft function in patients after solid organ transplantation is still uncertain. Our study is based on a group of 78 cases after liver (LTR) and/or renal transplantation (RTR) with 91 deliveries in the past 12 years in the 1st Department of Obstetrics and Gynecology, Warsaw Medical University. We compared duration of pregnancy, mode of delivery, weight of neonates, and graft function. Rate of preterm delivery was very high (74% RTR and 43% LTR). The average duration of pregnancy was shorter in the RTR than in the LTR group (34.7 vs. 36.8 p<0.001) with a high rate of cesarean sections (81.4% in RTR and 68.1% in LTR). Birth weight in LTR (2898 g) was higher than in RTR (2248 g) (p<0.0001). Currently, 29 RTR and 38 LTR have preserved graft function. Thus, graft survival in the study group is longer than in the general RTR or LTR population. Pregnancy after kidney or liver transplantation does not seem to increase the risk of graft loss, but is associated with a higher risk of maternal and fetal complications. In our data these complications occur more often in the RTR group.