Management and outcomes of 27 pregnancies in women with myeloproliferative neoplasms
dc.rights.license | open | en_US |
dc.contributor.author | LAPOIRIE, Joëlle | |
dc.contributor.author | CONTIS, Anne | |
hal.structure.identifier | Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases | |
dc.contributor.author | GUY, Alexandre | |
dc.contributor.author | LIFERMANN, François | |
hal.structure.identifier | Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases | |
dc.contributor.author | VIALLARD, Jean-Francois | |
dc.contributor.author | SENTILHES, Loïc | |
hal.structure.identifier | Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases | |
dc.contributor.author | JAMES, Chloé | |
dc.contributor.author | DUFFAU, Pierre | |
dc.date.accessioned | 2020-10-19T14:43:14Z | |
dc.date.available | 2020-10-19T14:43:14Z | |
dc.date.issued | 2020 | |
dc.identifier.issn | 1476-4954 | en_US |
dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/11441 | |
dc.description.abstractEn | Introduction: Philadelphia-negative myeloproliferative neoplasms (MPNs) greatly increase the risk of maternal and fetal complications during pregnancy. Currently, international agreements regarding the management of these women are lacking.Patients and methods: Our study aimed to assess the current management and outcomes of MPN pregnancies in a French cohort. We retrospectively analyzed 27 pregnancies in women with MPNs that were associated with a specific mutation. Nineteen pregnancies in nine women with essential thrombocythemia and eight pregnancies in five women with polycythemia vera were identified.Results: Our study showed 70% live births, but only 30% uneventful pregnancies. Fetal complications were mainly early spontaneous abortions (22%), fetal growth restriction (15%), and premature delivery (15%). Maternal issues were divided between thrombosis (15%) and hemorrhages (11%). High rates of preeclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome (15%) were reported. Uterine artery Doppler was performed in 70% pregnancies. Abnormal Doppler results were found in 43% pregnancies. Pregnancies with high platelet counts and packed cell volume remaining static or increasing ended with fetal death and utero-placental dysfunction. According to expert consensus, most of the pregnancies (67%) could be stratified in the high risk group and had a bad obstetrical outcome, with 50% standard-risk pregnancies versus 22% high-risk pregnancies that were uneventful. Higher risk pregnancies were prescribed heparin and/or interferon α in 72%.Conclusions: The prognosis of these pregnancies remains very bad and may be improved by a more effective collaboration between specialists as well as a therapeutic intensification including heparin and interferon α. | |
dc.language.iso | EN | en_US |
dc.subject | HELLP | |
dc.subject | High-risk pregnancy | |
dc.subject | Myeloproliferative neoplasms | |
dc.subject | Postpartum hemorrhage | |
dc.subject | Preeclampsia | |
dc.subject | Preterm birth | |
dc.subject | Stillbirth | |
dc.subject | Thrombosis | |
dc.subject.en | Recherche | |
dc.title.en | Management and outcomes of 27 pregnancies in women with myeloproliferative neoplasms | |
dc.title.alternative | J Matern Fetal Neonatal Med | en_US |
dc.type | Article de revue | en_US |
dc.identifier.doi | 10.1080/14767058.2018.1484097 | en_US |
dc.subject.hal | Sciences du Vivant [q-bio]/Médecine humaine et pathologie | en_US |
dc.identifier.pubmed | 29945475 | en_US |
bordeaux.journal | The Journal of Maternal-Fetal & Neonatal Medicine | en_US |
bordeaux.page | 49–56 | en_US |
bordeaux.volume | 33 | en_US |
bordeaux.hal.laboratories | Biologie des maladies cardiovasculaires - U1034 | en_US |
bordeaux.issue | 1 | en_US |
bordeaux.institution | Université de Bordeaux | en_US |
bordeaux.peerReviewed | oui | en_US |
bordeaux.inpress | non | en_US |
hal.export | false | |
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