Document Detail


Management of Philadelphia negative chronic myeloproliferative disorders in pregnancy.
MedLine Citation:
PMID:  18617299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The management of pregnancy in Philadelphia negative chronic myeloproliferative disorders (CMPDs) is an increasingly frequent problem. In the literature, most pregnancies are reported for women with essential thrombocythemia (ET) with about 400 pregnancies in about 200 women. In ET, first trimester abortion is the most frequent complication occurring in about one third of pregnancies. Interestingly, the incidence of maternal complications is relatively low with 3% for major thromboembolic and 2% for major bleeding events. The presence of the Jak2 mutation seems to be an independent predictor of pregnancy complications. Pregnancies in ET should be stratified according to underlying risk factors in low, high and highest risk pregnancies. Women with low risk pregnancies are treated with low-dose aspirin, whereas women with high and higher risk pregnancies may benefit from low-dose aspirin plus interferon alpha +/- low molecular weight heparin throughout pregnancy and at least for six weeks post-partum. In polycythemia vera (PV) there is only very few information on pregnancy outcome with 36 pregnancies reported in the literature. According to these data pregnancy in PV is per se a high risk situation. Accordingly, all women with PV should be treated with low-dose aspirin. Some pregnant PV patients may benefit from a more intensive therapy including interferon alpha +/- low molecular weight heparin throughout pregnancy and at least for six weeks post-partum.
Authors:
Martin Griesshammer; Sabine Struve; Tiziano Barbui
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2008-07-09
Journal Detail:
Title:  Blood reviews     Volume:  22     ISSN:  0268-960X     ISO Abbreviation:  Blood Rev.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-04     Completed Date:  2008-12-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708558     Medline TA:  Blood Rev     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  235-45     Citation Subset:  IM    
Affiliation:
Department of Medicine III, Robert-Koch-Strasse 8, D-89081 Ulm, Federal Republic of Germany. martin.griesshammer@medizin.uni-ulm.de
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MeSH Terms
Descriptor/Qualifier:
Aspirin / therapeutic use
Female
Heparin, Low-Molecular-Weight / therapeutic use
Humans
Platelet Aggregation Inhibitors / therapeutic use*
Polycythemia Vera / drug therapy*
Pregnancy
Pregnancy Complications, Hematologic / drug therapy*
Thrombocythemia, Essential / drug therapy*
Chemical
Reg. No./Substance:
0/Heparin, Low-Molecular-Weight; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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