• Jennifer K Durst and Roxane M Rampersad.
• Fellow.
• Obstet Gynecol Surv. 2015 Jun 1; 70 (6): 408-18.

ImportanceAdvances in solid-organ transplantation have allowed many women to reach reproductive potential, and pregnancy is no longer a rarity for these women.ObjectiveTo identify (1) potential complications to allograft function posed by pregnancy, (2) expected perinatal outcomes in women with solid-organ transplants, (3) risks of potential immunosuppressant regimens, (4) safety of lactation, and (5) contraceptive options for women with solid-organ transplants.Evidence AcquisitionSingle-center, registry data, and previous systematic reviews were evaluated in women with solid-organ transplants to identify the objectives of this review. In addition, recommendations from public health organizations were examined in regard to safety of medications and contraceptive methods.ResultsWomen with solid-organ transplants are at risk for premature birth, low birth weight, cesarean delivery, and hypertensive disorders of pregnancy. Most immunosuppressant regimens are safe; however, mycophenolate mofetil should be avoided. Lactation with tacrolimus, cyclosporine, azathioprine, and prednisone appears safe. Long-acting reversible contraceptive methods are safe and effective for transplant recipients.ConclusionsMany successful pregnancies have been achieved in women following transplantation; however, optimal perinatal outcomes require stable allograft function.RelevanceAs more women are becoming pregnant after organ transplantation, a review of obstetric recommendations and perinatal outcome is warranted.

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