Primary thrombocythaemia in pregnancy

Abstract

Nine pregnancies in six patients with primary thrombocythaemia are reported. Eight pregnancies resulted in the delivery of normal infants. One pregnancy ended in spontaneous abortion at 7 weeks gestation. One pregnancy was complicated by superficial thrombophlebitis and a postpartum haemorrhage. We suggest that pregnancy in patients with primary thrombocythaemia can have a favourable outcome, but requires close monitoring. Administration of aspirin during pregnancy may be of benefit.

Risk of venous thromboembolism in pregnant women with essential thrombocythemia: a systematic review and meta-analysis

“…Of the 18 studies that reported VTE outcomes and antepartum LMWH prophylaxis use, there were 0 antepartum VTE events among 82 pregnancies with LMWH use (0%; 95% CI, 0.0-5.7; I 2 0%), and 8 antepartum VTE events among 407 pregnancies without LMWH use (2.5%; 95% CI, 1.3-4.3; I 2 0%) ( Table 2). [4][5][6][7][14][15][16][17][18][19][20][21][22][23]25,[28][29][30][31] Among the 18 studies that reported VTE outcomes and ASA use during pregnancy, there were 6 antepartum VTE events among 283 pregnancies with ASA use (2.9%; 95% CI, 1.3-5.1; I 2 0%), and 2 antepartum VTE events among 158 pregnancies without ASA use (2.8%; 95% CI, 0.9-5.8; I 2 0%). Of the subgroup of 212 pregnancies reported in which ASA was used alone without LMWH, there were 6 antepartum VTE events (4.2%; 95% CI, 2.0-7.1; I 2 0%).…”

“…Among the 16 studies that reported VTE outcomes and IFN use during pregnancy, there were 0 antepartum VTE events among 38 pregnancies with IFN use (0%; 95% CI, 0.0-11.9; I 2 0%), and 3 antepartum VTE events among 266 pregnancies without IFN use (2.0%; 95% CI, 0.7-3.9; I 2 0%). 6,[14][15][16][17][18][19][20][21][22][23]25,[28][29][30][31] Of the 38 pregnancies with IFN use: 14 received LMWH, 14 received no LMWH, and 10 had unknown LMWH use. Of the 266 pregnancies without IFN: 30 received LMWH, 156 received no LMWH, and 80 had unknown LMWH use.…”

Patients with essential thrombocytosis during pregnancy: Challenges and therapeutic dilemmas

“…Most of the patients have a history of abortions in the past [13,14]; nevertheless, pregnancy complications including intrauterine growth retardation and preeclampsia have been reported [15]. Platelet apheresis was also performed complementary with ASA and low-molecular weight heparin (LMWH) [16,17].…”

“…Due to the increased percentage of abortions and pregnancy complications in untreated patients as results of thrombosis and abnormal placenta blood circulation, the addition of low-dose ASA showed encouraging results. There are reports in patients with a history of abortions that had a successful pregnancy after single treatment with ASA [5,6,8,9,16,[19][20][21][22][23][24][25]. ASA was also initiated in some cases, if not at the beginning of pregnancy, when a pregnancy complication was present like hypertension disorders, abrutio placenta or IUGR and premature delivery [5,8,[25][26][27].…”

“…In pregnancies that were considered "high risk" or there was a history of abortions or pregnancy complications including intrauterine fetal death IFNa was continued in all trimesters or the initiation was done when other complications were present like IUGR. In almost all cases IFNa was combined with ASA [9,16,25,31,[46][47][48][49][50][51].…”