Retrospective evaluation of anesthetic techniques in pregnant women with renal transplantation

Abstract

Background/aim: The aim of this study was to evaluate anesthesia management in cesarean operation of pregnant women whounderwent renal transplantation and the effects on postoperative renal function, retrospectively.Materials and methods: After obtaining the approval of the ethics committee of our hospital, the records of pregnant women whounderwent kidney transplantation and cesarean section between 2007 and 2017 were retrospectively analyzed. The patients’ demographicdata, concomitant disease history, the treatment received, and type of anesthesia were retrospectively evaluated and recorded in thefollow-up form.Results: It was found that a total of 47 women who underwent renal transplantation had 47 live births by cesarean section. The meanage of the pregnant women was 30 ± 5.34 years. The mean time between renal transplantation and conception was 95.34 ± 55.02months. It was found that 14 (29%) of a total of 47 patients had their first pregnancy. The number of patients with a gravidity of 4and above was 9 (19%). A total of 21 (44.7%) pregnant women had spontaneous miscarriage. Five (10.6%) patients were treated withcurettage for therapeutic purposes. Twenty-two (46%) of the patients whose immunosuppressive therapy was continuing were treatedwith azathioprine, tacrolimus, and prednisolone. The mean gestational age of delivery was 36.5 ± 1.59 weeks. The rate of prepregnancyhypertension diagnosis was 25.5% (n = 12), while the rate of developing gestational hypertension was 21.3% (n = 10). Spinal anesthesiawas administered to 42 (91%) of 47 patients who underwent cesarean section. In the preoperative period, the mean value of serum bloodurea nitrogen was 62.88 ± 41.97 mg/dL and the mean serum creatinine level was 3.21 ± 6.17 mg/dL. In the postoperative period, thesevalues were 44.4 ± 29.9 mg/dL and 1.91 ± 1.63 mg/dL, respectively. When the pre- and postoperative serum urea and creatinine levelswere compared, they were found to be lower in the postoperative period. However, there was no statistically significant difference (P >0.05). The mean weight of the newborns was determined as 2707.3 ± 501.5 g. While the number of newborns with a low birth weight(