EMBAR

Author:
Dr Sripathi Anusha, Dr Shobha , DR.Goli Mahalaxmi , Dr Renu Sahani , Dr Radha, Dr Amani Chintala
MS OBGYN , Senior Resident, Gandhi Hospital

DOI: doi.org/10.58924/rjmp.v4.iss5.p3

Published Date: 05-Dec, 2025

Keywords: Immunosuppressive,Acute graft rejection,lupus nephritis

Abstract:
BACKGROUND Pregnancy with renal disease is associated with high risk for both mother and fetus with adverse outcomes. Criteria for considering pregnancy in k/c/o of SLE with renal transplanted patients include good post-transplant health for 2 years, stable allograft function with a serum creatinine <1.5 mg/dl, absence of rejection, control of blood pressure, absence of proteinuria and SLE under remission for past 6 months. CASE This is a case where 29yr old G2P1L1 with 26 weeks GA with SLE in remission and renal transplant recipient developed preclampsia and progressively increasing proteinuria and creatinine levels ending in acute graft rejection which was medical managed and pregnancy continued .Post natal period was uneventful and discharged on immunosuppressive therapy. With close medical and obstetric follow-up successful outcome of mother and infant is possible. DISCUSSED AND CONCLUSION A meticulous diagnostic approach is necessary to differentiate between lupus nephritis,preclampsia with severe features and acute graft rejection as preclampsia needs termination of pregnancy while graft rejection can be medically managed.Even with a stable graft function for 2yrs it is superimposed preclampsia that is increasing the risk of graft rejection. .

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