Perioperative management of aplastic anemia in pregnancy with platelet transfusion refractoriness

Onishi, Eiko; Fujita, Kazuko; Yokono, Satoshi

doi:10.1007/bf03021717

Cited by 3 publications

(2 citation statements)

References 5 publications

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“… 70 If PTR is detected in a pregnant patient who has received blood transfusions, then HLA- and/or HPA-compatible platelet transfusions are indicated. 71 …”

Section: Maternal and Fetal Considerations In Aplastic Anemia In Pregmentioning

confidence: 99%

Aplastic anemia during pregnancy: a review of obstetric and anesthetic considerations

Riveros-Pérez

Hermesch

Barbour

et al. 2018

IJWH

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Aplastic anemia is a hematologic condition occasionally presenting during pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management is challenging, and treatment requires a coordinated effort by an interdisciplinary team, in order to provide safe care to these patients. In this review, we describe the current state of the literature as it applies to the complexity of aplastic anemia in pregnancy, focusing on pathophysiologic aspects of the disease in pregnancy, as well as relevant obstetric and anesthetic considerations necessary to treat this challenging problem. A multidisciplinary-team approach to the management of aplastic anemia in pregnancy is necessary to coordinate prenatal care, optimize maternofetal outcomes, and plan peripartum interventions. Conservative transfusion management is critical to prevent alloimmunization. Although a safe threshold-platelet count for neuraxial anesthesia has not been established, selection of anesthetic technique must be evaluated on a case-to-case basis.

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“… 70 If PTR is detected in a pregnant patient who has received blood transfusions, then HLA- and/or HPA-compatible platelet transfusions are indicated. 71 …”

Section: Maternal and Fetal Considerations In Aplastic Anemia In Pregmentioning

confidence: 99%

Aplastic anemia during pregnancy: a review of obstetric and anesthetic considerations

Riveros-Pérez

Hermesch

Barbour

et al. 2018

IJWH

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“…7 According to one theory, a population of primitive CD34 progenitors responsible for cellular proliferation and regeneration is produced in maternal bone marrow in response to interaction with umbilical cord blood cells via immunologic signals. 8 Pregnancy is also sometimes accompanied by gestational thrombocytopenia and relative leukocytosis. The factors responsible for the observed thrombocytopenia in pregnant patients with aplastic anemia are yet to be defi nitively elucidated.…”

Section: Introductionmentioning

confidence: 99%

Management of Aplastic Anemia in Pregnancy: A Case Report

Djusad

Malano

2020

Indones J Obstet Gynecol

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Aplastic anemia was first recognized by Ehrlich in 1888, although the pathogenesis of aplastic anemia has remained elusive. Aplastic anemia is a subtype of anemia characterized by pancytopenia and a hypocellular bone marrow which are the risk factor can be due to chemicals, drugs, infections, irradiation, leukemia, and inherited disorders. There is universal agreement that pregnancy complicated by aplastic anemia is a serious condition. The risk to the mother is mainly in the form of hemorrhage meanwhile the fetus may suffer from growth restriction and even intrauterine death. Most of the fetal complications are due to maternal anemia. We here present one cases of pregnancy complicated by aplastic anemia, which were seen within 3 months at our hospital. This high incidence is because the hospital is a top national care referral unit with good hematology and blood bank support. Keyword: aplastic anemia, pregnancy, pancytopenia Abstrak Anemia aplastik pertama kali dikenali oleh Ehrlich pada tahun 1888, walaupun patogenesis anemia aplastik masih sulit dipahami. Anemia aplastik adalah subtipe anemia yang ditandai dengan pansitopenia dan hiposeluler sumsum tulang yang merupakan faktor risiko yang dapat disebabkan oleh bahan kimia, obat-obatan, infeksi, iradiasi, leukemia, dan kelainan bawaan. Terdapat kesepakatan universal bahwa komplikasi kehamilan berupa anemia aplastik merupakan kondisi serius. Risiko kepada ibu hamil terutama dalam bentuk perdarahan sementara janin dapat mengalami hambatan dalam pertumbuhan dan bahkan kematian dalam kandungan. Sebagian besar komplikasi janin disebabkan oleh anemia pada maternal. Kami di sini menyajikan satu kasus komplikasi kehamilan berupa anemia aplastik, yang ditemukan dalam waktu 3 bulan di rumah sakit kami. Kejadian yang tinggi ini karena rumah sakit adalah unit rujukan perawatan nasional teratas dengan hematologi yang baik dan dukungan bank darah.

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Aplastic anaemia in pregnancy with severe thrombocytopenia refractory to platelet transfusion: a case and management plan

et al. 2009

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Aplastic anaemia is a rare haematological disorder during pregnancy, which when complicated by severe thrombocytopenia poses a significant maternal risk. A woman with aplastic anaemia and a platelet (PLT) count of 11 × 10(9)/L refractory to PLT transfusion required caesarean delivery. Proactive planning by a multidisciplinary team, large volume PLT transfusion prior to surgery and postoperative uterine artery embolization resulted in avoidance of mortality. Maternal preferences should be discussed in detail due to the high risk of maternal morbidity and mortality associated with severe aplastic anaemia. This report outlines a management plan to address the medical and ethical issues faced when caring for a pregnant patient with severe aplastic anaemia and severe thrombocytopenia. We credit the good outcome to our proactive multidisciplinary approach.

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Perioperative management of aplastic anemia in pregnancy with platelet transfusion refractoriness

Cited by 3 publications

References 5 publications

Aplastic anemia during pregnancy: a review of obstetric and anesthetic considerations

Aplastic anemia during pregnancy: a review of obstetric and anesthetic considerations

Management of Aplastic Anemia in Pregnancy: A Case Report

Aplastic anaemia in pregnancy with severe thrombocytopenia refractory to platelet transfusion: a case and management plan

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