The first reported post-transplant pregnancy occurred in March 1958 and was published several years later.1 This female recipient had received a kidney transplant from her identical twin sister and delivered a healthy baby boy by cesarean section. Over the ensuing years, numerous case reports, single center reports, surveys, and registry publications have reported outcomes of pregnancies in female transplant recipients. Since even large individual centers have limited experience with post-transplant pregnancies, registry data and surveys provide important information for comparing outcomes among different recipient groups.

In 1991, the National Transplantation Pregnancy Registry (NTPR) was established at Thomas Jefferson University to study the safety of pregnancy outcomes and sequelae for both female transplant recipients and male transplant recipients who father pregnancies. To date we have received entries on 732 female recipients (1121 pregnancies) and on 855 pregnancies fathered by 603 male recipients. Here we review recent reports in the literature as well as current findings and background information from the registry. Because of the concerns of immunosup-pressive agents on fetal development, a brief review of these agents will follow. Additionally, we will discuss obstetrical management issues for female organ recipients.

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