*Purpose: Pregnancies after renal transplantation (RT) are classified as high risk and are reported to generate maternal and foetal complications. The aim of this study is to collect and analyse information about the characteristics of renal transplant recipients who underwent a pregnancy after transplantation.

*Methods: Data on the transplant recipients who underwent a pregnancy between September 2006 and February 2017 was collected using the UK Obstetric Surveillance System (UKOSS) forms. Results were compared with the general pregnancy outcomes reported by Public Health England (GOV.UK)

*Results: From twenty pregnancies monitored after RT, one resulted in stillbirth (5%) there were no miscarriages reported. One patient developed eclampsia (5%), two gestational diabetes (10%) and 30% hypertension. Graft dysfunction was seen 15% of parturients. More than 65% of the patients required caesarean section (LSCS) and 15 %. The most frequent surgical complication was peripartum hemorrhage, one in five deliveries (20%). Also 25% of the patients required escalation to critical care post-delivery. Pre-term delivery (<37 weeks) was seen in 65% of the cohort. When compared to the general pregnancy outcomes published on Public Health England, the infant mortality rate seems to be similar, the stillborn incidence is the same 5% however other complications are more predominant in the transplant population. The LSCS is expected to be 29% in the general population whereas in our group of patients it raised to 65%. Low birth weight for all pregnancies was 8.7% compared to 45% in transplant recipients.

*Conclusions: Pregnancy after RT remains a high risk pregnancy. Peripartum complications, requirement for caesarean section, induced labor, peripartum hemorrhage, and maternal critical care admission seem to be more frequent. Foetal outcome seem sub optimal as preterm and low birth weights are noticed more frequently when compared to the general population. This information could be utilized to inform mothers of the risk of undertaking pregnancy following RT. A multi-disciplinary team approach should be utilized when caring for parturient after RT to achieve best outcomes.

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