Pregnancy in a patient with renal allograft, type 1 diabetes mellitus, and combined heart disease: Course complexities, therapy approaches

Kirsanova T.V., Kravchenko N.F., Runikhina N.K., Elenshleger G.A., Esayan R.M., Koshel L.V., Vinogradova M.A., Kandidova I.E.

1Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow 117997, Ac. Oparina str. 4, Russia 2Russian Gerontology Research Center, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow 129226, 1st Leonova str. 16, Russia 3Moscow Clinical Research Center, Moscow Healthcare Department, Moscow 111123, Enthusiasts shosse 86, Russia 4Academician V.I. Shumakov Research Center of Transplantology and Artificial Organs, Ministry of Health of Russia, Moscow 123182, Schukinskaya str. 1, Russia
Background. Every case of successful pregnancy in women with renal allograft is of practical interest to specialists of different profiles.
A case report. The paper describes a rare clinical observation of the course of pregnancy in a patient with a compromised somatic history of severe type 1 diabetes mellitus on insulin pump delivery with renal allograft, reduced function, grade 3 hypertension that is difficult to cure with triple therapy, and heart defect identified during pregnancy with moderate pulmonary hypertension.
Conclusion. Our demonstrated case illustrates the difficulties the physicians of different profiles face when managing pregnancy in patients with extragenital diseases. The paper describes the characteristics of the course of pregnancy, as well as the possibility of a favorable outcome for the mother and her fetus, provided the teamwork of specialists of different profiles.

Keywords

allograft
type 1 diabetes mellitus
insulin pump
acquired heart disease
pulmonary hypertension
pregnancy

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Received 16.12.2016

Accepted 23.12.2016

About the Authors

Kirsanova Tatiana V., PhD Senior Researcher of the Therapeutic Department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4
Kravchenko N.F., PhD, Researcher of the 1st department of pathology of pregnancy, Research Center of Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4
Runikhina N.K., MD, Deputy Director for scientific and medical work of the Russian Gerontology Research and Clinical Center.
129226, Russia, Moscow, 1st Leonova str. 16
Elenshleger G.A., Doctor of functional diagnostics, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4
Esayan R.M., Head of the therapeutic department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4
Koshel L.V., PhD, senior researcher of Moscow Clinical Research Center. 111123, Russia, Moscow, Enthusiasts shosse 86
Vinogradova M.A., PhD, Head of the Division of Hematology and Clinical Reproductive Hemostasis, Research Center of Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4
Kandidova I.E., Honoured Doctor of Russia, PhD, Leading the Department of Nephrology Kidney and liver transplantation,
Academician V.I. Shumakov Research Center of Transplantation and Artificial Organs, Ministry of Health of Russia. 123182, Russia, Moscow, Schukinskaya str. 1

For citations: Kirsanova T.V., Kravchenko N.F., Runikhina N.K., Elenshleger G.A., Esayan R.M., Koshel L.V., Vinogradova M.A., Kandidova I.E. Pregnancy in a patient with renal allograft, type 1 diabetes mellitus, and combined heart disease: Course complexities, therapy approaches. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (3): 165-70. (in Russian)
http://dx.doi.org/10.18565/aig.2017.3.165-70

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