According to a new study, a planned caesarean section may not be the safest delivery method for transplanted women. Caesarean delivery rates are rising, especially for pregnant women at high risk of having an organ transplant. In the United States, cesarean delivery accounts for 31% of all births, while pregnant women who have had a kidney transplant account for 62.6% cesarean delivery and 44.6% liver transplantation.
UCLA-led study published on October 4th JAMA network open We have found that pregnant people who have had a kidney or liver transplant can be tested for delivery (vaginal birth) without increasing their risk to their transplant or their baby.
The study included 1,865 pregnant women aged 18-48 years over 50 years.In the study cohort, 1,435 women received kidney transplants and 430 received Liver transplant.. Of the delivery attempts, 73% ended with vaginal delivery.
The study found that women who gave birth to the vagina had improved baby outcomes without giving birth. Increasing risk For the health of the mother.However Risk factor Caesarean delivery after labor is especially important Kidney transplant Receiver. The risk of placental abruption was 13-fold higher and the chance of developing pre-pregnancy diabetes was 5-fold higher.
David Gefen, Associate Professor of Obstetrics and Gynecology, MD, Jarda Afshah, MD, said: Senior Author of UCLA School of Medicine and Research. “But now there is more evidence to suggest that this continuous practice is not necessary because delivery attempts are safe for pregnant transplant recipients.”
Studies also show that babies have been more successful in labor trials. The prevalence of newborns, which is a risk of serious injury or death during the neonatal period, occurred in only 6% to 10% of patients with kidney and liver in the delivery trial, compared to up to 20% of cesarean delivery. Babies born after a caesarean section were at more than twice the risk of short-term and long-term respiratory problems, and some babies needed a ventilator.
“One of the most impressive discoveries is Labor Although ended with a Caesarean section, these babies were still better than the babies after the scheduled surgery. this is, Transplant After discussing the risks and benefits with the medical team, we should consider trying vaginal delivery, “said Dr. Ophelia Yin, Physician in Obstetrics and Gynecology at the School of Medicine and lead author of the study.
Ophelia Yin et al, Modes of Obstetric Delivery in Kidney and Liver Transplant Recipients and Related Maternal, Neonatal, and Graft Prevalence, 5-Year Clinical Practice, JAMA network open (2021). DOI: 10.1001 / jamanetworkopen.2021.27378
University of California, Los Angeles
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