Twin pregnancy after kidney transplantation: what's on? A case report and review of literature

Objective: To describe the maternal and neonatal outcome of a twin pregnancy in a renal transplant recipient patient and reviewe the current literature on this theme. Methods: A case of 27 years old woman with a twin pregnancy arisen spontaneously in a renal transplant recipient from living donor characterized by an episode of slight anemia, mild hypertension, and a subsequent optimal maternal/neonatal outcome. During admission, the patient was treated with iron therapy, nifedipine, and methyldopa due to anemia and hypertension episodes. Strict monitoring of patient's blood and urinary parameters, ultrasound fetues evaluation, and fetal lung maturity induction was performed. Results: Both anemia and hypertension were controlled through pharmacological intervention. During the second admission, the serum creatinine was 185 mmol/L and urine examination showed a proteinuria of 0.3 g/L. Ultrasound evaluation showed fetal wellness for both twin. Patient underwent caesarean section and gave birth to two healthy babies. Conclusions: It is necessary to define more strict criteria for the management of women with twin pregnancy and a history of renal transplantation to ensure the better maternal and neonatal outcome.