PREGNANCY AFTER HEART OR HEART-LUNG TRANSPLANTATION - A SERIES OF 10 PREGNANCIES

Objective To evaluate pregnancy after heart or heart-lung transplantat ion in France. Design A questionnaire survey of all French centres per forming heart and heart-lung transplants provided an exhaustive regist ry on pregnancy after transplantation. Methods A questionnaire was sen t to 36 centres. Anonymous reports on transplantation and subsequent p regnancies between 1984 and 1996 were analysed. Results Of 1290 heart and 120 heart-lung transplantation performed during the study period, 10 pregnancies (seven after heart transplantation and three after hear t-lung transplantation) were reported in nine women who were delivered of 11 infants. High blood pressure complicated nine pregnancies and s evere pre-eclampsia occurred in two. One woman developed Kaposi sarcom a of the cervix. Delivery at 35 weeks gestation (27-39) was by caesare an section in 50% cases. Mean birthweight was 1990g (700-2880g) and 50 % of the infants had a birthweight < tenth centile. One infant develop ed cardiomyopathy as a condition inherited from her mother, and congen ital hepatitis B was diagnosed in another. Conclusions Pregnancy after heart and heart-lung transplantation is feasible and can be successfu l, but this should be planned when cardiac and respiratory functions a re stable. Adequate obstetrical and genetic counselling should be prov ided.