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Management and outcomes of 27 pregnancies in women with myeloproliferative neoplasms

dc.rights.licenseopenen_US
dc.contributor.authorLAPOIRIE, Joëlle
dc.contributor.authorCONTIS, Anne
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorGUY, Alexandre
dc.contributor.authorLIFERMANN, François
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorVIALLARD, Jean-Francois
dc.contributor.authorSENTILHES, Loïc
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorJAMES, Chloé
dc.contributor.authorDUFFAU, Pierre
dc.date.accessioned2020-10-19T14:43:14Z
dc.date.available2020-10-19T14:43:14Z
dc.date.issued2020
dc.identifier.issn1476-4954en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/11441
dc.description.abstractEnIntroduction: 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.isoENen_US
dc.subjectHELLP
dc.subjectHigh-risk pregnancy
dc.subjectMyeloproliferative neoplasms
dc.subjectPostpartum hemorrhage
dc.subjectPreeclampsia
dc.subjectPreterm birth
dc.subjectStillbirth
dc.subjectThrombosis
dc.subject.enRecherche
dc.title.enManagement and outcomes of 27 pregnancies in women with myeloproliferative neoplasms
dc.title.alternativeJ Matern Fetal Neonatal Meden_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1080/14767058.2018.1484097en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
dc.identifier.pubmed29945475en_US
bordeaux.journalThe Journal of Maternal-Fetal & Neonatal Medicineen_US
bordeaux.page49–56en_US
bordeaux.volume33en_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires - U1034en_US
bordeaux.issue1en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
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