Abstract：
BACKGROUND: Lung transplantation is well-established treatment for patients with advanced lung dysfunction in cystic fibrosis (CF). Pregnancy in CF lung transplant recipients is feasible, although it still remains challenging for even professionals and demands a multidisciplinary approach.
METHODS: We report the case of pregnancy in a 22-year-old woman after lung transplantation (LTx) due to end-stage respiratory failure in the course of CF. The interval from transplant to conception was 2.5 years. In 2019, orthotopic LTx was performed and a 3-drug immunosuppressive scheme was used-tacrolimus, mycophenolate mofetil, and prednisolone. There were no complications in the postoperative course. In April 2022, the patient was confirmed pregnant. All fetotoxic or teratogenic drugs were discontinued. Throughout the whole pregnancy, the patient was regularly monitored in the transplant and obstetrics centers. Due to the vaginal bleeding and irregular contractions at the 33 weeks of pregnancy, the course of steroids was administered. At 38 weeks and 5 days of gestation, she presented premature rupture of membranes. The caesarean section was performed because of breech presentation of the fetus. A live, term daughter was born and according to the screening test she does not have CF. Currently, 12 months after the delivery, the mother\'s lung function is good.
CONCLUSIONS: Getting pregnant and having a safe pregnancy after LTx is possible, but it requires a specialized and individual approach. The patient should be well informed about possible complications and risks including graft failure. The patient\'s attitude and her cooperation with doctors play a major role.
METHODS: We report the case of pregnancy in a 22-year-old woman after lung transplantation (LTx) due to end-stage respiratory failure in the course of CF. The interval from transplant to conception was 2.5 years. In 2019, orthotopic LTx was performed and a 3-drug immunosuppressive scheme was used-tacrolimus, mycophenolate mofetil, and prednisolone. There were no complications in the postoperative course. In April 2022, the patient was confirmed pregnant. All fetotoxic or teratogenic drugs were discontinued. Throughout the whole pregnancy, the patient was regularly monitored in the transplant and obstetrics centers. Due to the vaginal bleeding and irregular contractions at the 33 weeks of pregnancy, the course of steroids was administered. At 38 weeks and 5 days of gestation, she presented premature rupture of membranes. The caesarean section was performed because of breech presentation of the fetus. A live, term daughter was born and according to the screening test she does not have CF. Currently, 12 months after the delivery, the mother\'s lung function is good.
CONCLUSIONS: Getting pregnant and having a safe pregnancy after LTx is possible, but it requires a specialized and individual approach. The patient should be well informed about possible complications and risks including graft failure. The patient\'s attitude and her cooperation with doctors play a major role.
摘要：
背景：肺移植是囊性纤维化（CF）晚期肺功能障碍患者的公认治疗方法。CF肺移植受者的妊娠是可行的，尽管对于专业人士来说仍然具有挑战性，并且需要多学科的方法。
方法：我们报告了一例22岁女性在CF过程中因终末期呼吸衰竭而进行肺移植（LTx）后妊娠的病例。从移植到受孕的间隔为2.5年。2019年，进行了原位LTx，并使用了3种药物的免疫抑制方案-他克莫司，霉酚酸酯，和泼尼松龙。术后无并发症发生。2022年4月，患者被确认怀孕。停用所有胎儿毒性或致畸药物。在整个怀孕期间，患者在移植和产科中心接受定期监测.由于怀孕33周时阴道出血和不规则收缩，服用类固醇的过程。在妊娠38周零5天，她提出胎膜早破。剖腹产是由于胎儿的臀位。一个活的，足月女儿出生，根据筛查测试，她没有CF。目前,交货后12个月，母亲的肺功能良好。
结论：在LTx后怀孕并安全怀孕是可能的，但它需要一个专门和个人的方法。患者应充分了解可能的并发症和风险，包括移植失败。病人的态度和她与医生的合作起着重要作用。
方法：我们报告了一例22岁女性在CF过程中因终末期呼吸衰竭而进行肺移植（LTx）后妊娠的病例。从移植到受孕的间隔为2.5年。2019年，进行了原位LTx，并使用了3种药物的免疫抑制方案-他克莫司，霉酚酸酯，和泼尼松龙。术后无并发症发生。2022年4月，患者被确认怀孕。停用所有胎儿毒性或致畸药物。在整个怀孕期间，患者在移植和产科中心接受定期监测.由于怀孕33周时阴道出血和不规则收缩，服用类固醇的过程。在妊娠38周零5天，她提出胎膜早破。剖腹产是由于胎儿的臀位。一个活的，足月女儿出生，根据筛查测试，她没有CF。目前,交货后12个月，母亲的肺功能良好。
结论：在LTx后怀孕并安全怀孕是可能的，但它需要一个专门和个人的方法。患者应充分了解可能的并发症和风险，包括移植失败。病人的态度和她与医生的合作起着重要作用。
