Successful pregnancy in a woman of late reproductive age with type 1 diabetes mellitus after combined pancreas — kidney transplantation

Women of reproductive age with type 1 diabetes mellitus (DM) and chronic kidney disease stage 5 after successful combined pancreas-kidney transplantation (CPKT) can experience spontaneous pregnancies with a favorable outcome. However, those pregnancies are associated with a high risk of complication...

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Main Authors: E. I. Prokopenko, F. F. Burumkulova, I. G. Nikolskaya, T. S. Kovalenko, V. A. Petrukhin
Format: Article
Language:English
Published: Endocrinology Research Centre 2024-09-01
Series:Сахарный диабет
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Online Access:https://www.dia-endojournals.ru/jour/article/view/13149
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author E. I. Prokopenko
F. F. Burumkulova
I. G. Nikolskaya
T. S. Kovalenko
V. A. Petrukhin
author_facet E. I. Prokopenko
F. F. Burumkulova
I. G. Nikolskaya
T. S. Kovalenko
V. A. Petrukhin
author_sort E. I. Prokopenko
collection DOAJ
description Women of reproductive age with type 1 diabetes mellitus (DM) and chronic kidney disease stage 5 after successful combined pancreas-kidney transplantation (CPKT) can experience spontaneous pregnancies with a favorable outcome. However, those pregnancies are associated with a high risk of complications: arterial hypertension, preeclampsia, premature birth, progression of diabetic retinopathy. During pregnancy, both gestational diabetes and spontaneous hypoglycemia can develop. This article presents a description of the clinical case of a 42-year-old patient with DM type 1, in whom pregnancy occurred 2 years after successful CPKT. Blood pressure was normal, the fundus condition was stable after previous treatment. The patient received tacrolimus and minimal dose of corticosteroids, at 13 weeks acetylsalicylic acid was prescribed to prevent preeclampsia. At 30 weeks nocturnal episodes of hypoglycemia appeared that were treated by additional intake of carbohydrates with an average glycemic index in combination with animal fats and proteins. At 36 gestational weeks caesarean section was performed due to premature rupture of membranes. A healthy girl was born with weight of 2140 g, height of 48 cm, Apgar score 7/8 points. The mother’s function of the kidney and pancreas grafts remained normal. Preconceptional counseling and multidisciplinary pregnancy management are important for patients after CPKT.
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spelling doaj-art-9c7d6642d2704ebb852590e2adea7d982025-08-20T02:29:39ZengEndocrinology Research CentreСахарный диабет2072-03512072-03782024-09-0127439540110.14341/DM1314911104Successful pregnancy in a woman of late reproductive age with type 1 diabetes mellitus after combined pancreas — kidney transplantationE. I. Prokopenko0F. F. Burumkulova1I. G. Nikolskaya2T. S. Kovalenko3V. A. Petrukhin4M.F. Vladimirsky Moscow Regional Clinical Research Institute; V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and GynaecologyM.F. Vladimirsky Moscow Regional Clinical Research Institute; V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and GynaecologyV.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and GynaecologyV.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and GynaecologyM.F. Vladimirsky Moscow Regional Clinical Research InstituteWomen of reproductive age with type 1 diabetes mellitus (DM) and chronic kidney disease stage 5 after successful combined pancreas-kidney transplantation (CPKT) can experience spontaneous pregnancies with a favorable outcome. However, those pregnancies are associated with a high risk of complications: arterial hypertension, preeclampsia, premature birth, progression of diabetic retinopathy. During pregnancy, both gestational diabetes and spontaneous hypoglycemia can develop. This article presents a description of the clinical case of a 42-year-old patient with DM type 1, in whom pregnancy occurred 2 years after successful CPKT. Blood pressure was normal, the fundus condition was stable after previous treatment. The patient received tacrolimus and minimal dose of corticosteroids, at 13 weeks acetylsalicylic acid was prescribed to prevent preeclampsia. At 30 weeks nocturnal episodes of hypoglycemia appeared that were treated by additional intake of carbohydrates with an average glycemic index in combination with animal fats and proteins. At 36 gestational weeks caesarean section was performed due to premature rupture of membranes. A healthy girl was born with weight of 2140 g, height of 48 cm, Apgar score 7/8 points. The mother’s function of the kidney and pancreas grafts remained normal. Preconceptional counseling and multidisciplinary pregnancy management are important for patients after CPKT.https://www.dia-endojournals.ru/jour/article/view/13149combined pancreas-kidney transplantationpregnancychronic kidney diseasediabetesimmunosuppressioncomplications of pregnancy
spellingShingle E. I. Prokopenko
F. F. Burumkulova
I. G. Nikolskaya
T. S. Kovalenko
V. A. Petrukhin
Successful pregnancy in a woman of late reproductive age with type 1 diabetes mellitus after combined pancreas — kidney transplantation
Сахарный диабет
combined pancreas-kidney transplantation
pregnancy
chronic kidney disease
diabetes
immunosuppression
complications of pregnancy
title Successful pregnancy in a woman of late reproductive age with type 1 diabetes mellitus after combined pancreas — kidney transplantation
title_full Successful pregnancy in a woman of late reproductive age with type 1 diabetes mellitus after combined pancreas — kidney transplantation
title_fullStr Successful pregnancy in a woman of late reproductive age with type 1 diabetes mellitus after combined pancreas — kidney transplantation
title_full_unstemmed Successful pregnancy in a woman of late reproductive age with type 1 diabetes mellitus after combined pancreas — kidney transplantation
title_short Successful pregnancy in a woman of late reproductive age with type 1 diabetes mellitus after combined pancreas — kidney transplantation
title_sort successful pregnancy in a woman of late reproductive age with type 1 diabetes mellitus after combined pancreas kidney transplantation
topic combined pancreas-kidney transplantation
pregnancy
chronic kidney disease
diabetes
immunosuppression
complications of pregnancy
url https://www.dia-endojournals.ru/jour/article/view/13149
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