Pregnancy and ADPKD

If you have ADPKD and are thinking about having a baby, here’s what you should know.

Getting Pregnant

Having ADPKD doesn’t mean you can’t get pregnant. But your fertility may depend on how well your kidneys work.

If they’re working like they should, your chances of getting pregnant are probably the same as if you didn’t have ADPKD. If your kidneys aren’t at 100%, you may have fewer reproductive hormones. That makes it harder to get pregnant.

For men, it’s similar. Low kidney function may lower your odds of fathering a child.

Pregnancy and ADPKD: Risk Factors

About 80% of women with ADPKD have a successful, normal pregnancy and deliver a healthy baby.

But two things may lead to complications: high blood pressure (your doctor will call it hypertension) and decreased kidney function. It’s important to get them both under control and have your doctor watch you closely during your pregnancy.

Everyone is different. Talk to your kidney specialist or your obstetrician about how ADPKD may affect your pregnancy.

Blood Pressure

If you’re trying to get pregnant and have high blood pressure, your doctor will work with you to get it under control before you conceive.

The meds that treat it can be dangerous to your baby.

To keep your blood pressure under control, take these steps:

• Stay at a healthy weight. Don’t gain too many extra pounds before or during pregnancy.
• Exercise regularly. Choose safe activities. Clear it with your doctor first.
• Ask your doctor about medication. Don’t stop taking yours unless the doctor tells you to.
• See your OB/GYN for regular visits.

Preeclampsia

High blood pressure during pregnancy can also lead to preeclampsia, a life- threatening condition for you and your baby where the placenta doesn’t get enough blood.

About 40% of pregnant women who have both ADPKD and high blood pressure get it. It can happen without warning. It’s important to have good medical care and be closely monitored by your doctor.

Preeclampsia can affect how your baby grows. It can lead to low birth weight, premature birth, or other serious problems. The risks for you include seizures and temporary worsening of kidney problems.

Early signs to watch for include:

• Sudden swelling of your hands, feet, or face
• Sudden vomiting or stomach pain
• Severe pain below your ribs
• Severe headache that painkillers don’t help
• Vison problems like blurring or flashing lights

See your doctor if you notice any of these signs.

Will My Baby Get ADPKD?

You can pass ADPKD to your baby. If you or your partner has it, there’s a 50% chance your baby will get the gene and develop the condition at some point in life.

Talk to a genetic counselor for more information. They can explain how parents pass ADPKD to children and help you understand your choices.

You can find a genetic counselor at many university medical centers. Your doctor or kidney specialist may also refer you to a specialist for genetic counseling.

How Does Pregnancy Affect ADPKD?

Pregnancy probably won’t affect the growth of cysts. And if your kidneys are working well, pregnancy shouldn’t cause more damage. You may have a slight loss in kidney function while you’re expecting, but it should go back to normal after the baby is born.

If your kidneys aren’t in good shape, the risks may rise. If you have severe kidney disease, pregnancy can permanently damage your kidney function. Talk to your doctor before planning a pregnancy.

If you have high blood pressure and four or more pregnancies, you may be slightly more likely to lose kidney function.

If you have high blood pressure when you’re pregnant, you may also have it after you give birth. The doctor may be able to give you medication that will help.

Making a Decision

Whether or not you have children is a personal choice. Talk to your partner about the risks involved. Take time to make an informed decision together.

Talk to your kidney doctor and OBGYN about ADPKD and pregnancy. Follow good prenatal care. Get monitored regularly.

Questions for Your Doctor

Ask your doctor:

• Based on my kidney function and blood pressure, how safe is it for me to get pregnant?
• Are my current medications safe during pregnancy?
• Will my medications affect my baby?
• Are there alternative medications?
• How can I keep my blood pressure under control?
• What tests will you give me during pregnancy?
• What symptoms of preeclampsia or other conditions should I look for?
• What can I do for a safe, healthy pregnancy?

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