A recent case report described the use of ganciclovir during pregnancy with no observed ill effects. One was an infant with Potter's syndrome and another a premature smaller twin with respiratory distress from birth. Analyzing outcomes as they relate to immunosuppressive therapies including Neoral, tacrolimus and MMF, showed one child who required surgery for ureteral obstruction and another for hydrocele . None of the newborns of fathers with MMF exposure were reported to have congenital defects. Managing Pregnancy Pregnancies in women recipients of all organ types must be considered high-risk.
Teamwork is essential.
Management requires measuring transplant function, blood work, blood pressure control, diagnosis and treatment of rejection , treatment of any infections and fetal moitoring many times during pregnancy. The woman's emotional attitude and the support she receives from her family must be carefully considered. Unless there are specific problems, however, spontaneous labor should be allowed. Vaginal delivery is the aim and cesarean section is only necessary for obstetric reasons. Higher steroids dose is necessary to cover delivery and completely uncontaminated technique is advisable at all times.