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Paul L. Ogburn, Jr, MD; John L. Kitzmiller, MD; John W. Hare, MD; Mark Phillippe, MD; Steven G. Gabbe, MD; Menachem Miodovnik, MD; George E. Tagatz, MD; Theodore C. Nagel, MD; Preston P. Williams, MD; Frederick C. Goetz, MD; Jose J. Barbosa, MD; David E. Sutherland, MD

JAMA. 1986;255(7):911-915.

Abstract
Nine cases of pregnancy complicated by diabetes and prior renal transplantation are reviewed. Maternal and fetal death occurred in a patient with foot and leg ulcers associated with preexisting peripheral vascular disease. Pregnancy-induced hypertension occurred in six cases. Spontaneous weight-bearing fractures occurred in two patients. No episodes of renal allograft rejection occurred. Evidence of fetal compromise was present in six cases. All fetuses were delivered by cesarean section prior to term, with live births occurring from 31 1/2 to 36 weeks' gestation. A single case of hypospadias was the only congenital defect. Prepregnancy screening for complications of diabetes and renal transplantation is advised and euglycemia should be achieved before and during pregnancy. Advanced diabetic vascular disease puts these gestations at significant risk.

(JAMA 1986;255:911-915)

Author Affiliations
From the Departments of Obstetrics and Gynecology (Drs Ogburn, Tagatz, Nagel, and Williams), Medicine (Drs Goetz and Barbosa), and Surgery (Dr Sutherland), University of Minnesota, Minneapolis; the Departments of Obstetrics and Gynecology and Reproductive Sciences, University of California-San Francisco (Dr Kitzmiller); the Joslin Diabetes Center, Boston (Drs Hare and Phillippe); the Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia (Dr Gabbe); and the Department of Obstetrics and Gynecology, University of Cincinnati Medical Center (Dr Miodovnik). Dr Ogburn is currently at Brown University, Providence, RI.

Footnotes
Reprint requests to Department of Maternal-Fetal Medicine, Women and Infants Hospital of Rhode Island, 50 Maude St, Providence, RI 02908 (Dr Ogburn).

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