Outcome Analysis of 34 Pregnancies in Women With Essential Thrombocythemia

Abstract

Patients with essential thrombocythemia have an increased risk of first-trimester abortion, which does not appear to be predictable or influenced by therapy. However, most patients are able to carry pregnancies to term with little or no risk of obstetric or thrombohemorrhagic complications during or after delivery. Overall, specific therapy during pregnancy did not appear to modify the clinical outcome, and the benefit of platelet apheresis during delivery could not be substantiated.

Successful pregnancies after recurrent abortions in mild essential thrombocythemia

“…However, it is noteworthy that our patients differ from the typical patients of Beressi et al (1) and Randi et al (2) in at least three important details. They were older, their obstetrical history was ominous without any other obvious pathology than essential thrombocythemia, and their platelet levels, although clearly elevated, were not as high as in the reports above.…”

“…Based on a recent retrospective outcome analysis of 34 pregnancies in women with essential thrombocythemia Beressi et al (1) conclude that these patients do have increased risk of first-trimester abortion, which does not, however, appear to be predictable or influenced by therapy. Most of the patients were able to carry pregnancies to term with little or no risk of obstetric or thrombohemorrhagic complications during or after delivery.…”

“…The platelet count is usually above 1000¿10 9 /L and the diagnosis should be made only after exclusion of other causes such as malignancies, collagen diseases, anemia and chronic inflammatory disorders, and other myeloproliferative diseases (1). The platelet count is usually above 1000¿10 9 /L and the diagnosis should be made only after exclusion of other causes such as malignancies, collagen diseases, anemia and chronic inflammatory disorders, and other myeloproliferative diseases (1).…”

Essential thrombocythaemia in children

“…When the disease affects women during pregnancy, multiple placental infarctions, presumably caused by platelet thrombi, may result in placental insufficiency. In the series of Beressi et al (1995), spontaneous abortion, mostly in the first trimester, occurred in 14 (45%) of 31 pregnancies. Other pregnancy‐related complications are less common, and include intrauterine fetal death, abruptio placentae, intrauterine growth retardation, and premature delivery (Beressi et al , 1995; Falconer et al , 1987; Mercer et al , 1988; Snethlage & Ten Cate, 1986; Thornley & Manoharan, 1994).…”

“…Since the disease occurs most often in late middle age and the elderly, ET in pregnancy is rare. Also, among 74 women younger than 50 years followed by Beressi et al (1995) only 18 became pregnant. When the disease affects women during pregnancy, multiple placental infarctions, presumably caused by platelet thrombi, may result in placental insufficiency.…”