Thrombocytémie essentielle et grossesse

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

“…Twelve studies included patients with ET based on established diagnostic criteria, according to the Polycythemia Vera Study Group (n 5 8), 6,14,17,[20][21][22]26,27,32 World Health Organization criteria (n 5 4), 7,[25][26][27]33 or other criteria (n 5 2). 16,23,34 The remaining 10 studies did not specify how the diagnosis of ET was established for the patients included.…”

“…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.…”

“…4,6,7,14,15,[18][19][20][21][23][24][25][26][27][28][29][30][31] Of the 14 studies that reported VTE outcomes and postpartum LMWH prophylaxis use, there were 0 postpartum VTE events among 96 pregnancies with LMWH use (0%; 95% CI, 0.0-4.6; I 2 0%) and 6 postpartum VTE events among 229 pregnancies without LMWH use (4.4%; 95% CI, 1.2-9.5; I 2 48%) ( Table 2). 4,6,7,14,15,[18][19][20][21]23,25,28,30,31 Insufficient detail was available with respect to IFN or ASA use and postpartum VTE.Bleeding risk. There were 12 antepartum bleeds reported in 756 pregnancies (2.3%; 95% CI, 0.9-4.4; I 2 46.9%), comprised of 9 placental abruptions, 2 epistaxis, and 1 vaginal bleeding in the first trimester of pregnancy.…”

“…There were 12 antepartum bleeds reported in 756 pregnancies (2.3%; 95% CI, 0.9-4.4; I 2 46.9%), comprised of 9 placental abruptions, 2 epistaxis, and 1 vaginal bleeding in the first trimester of pregnancy. There were 11 postpartum bleeds reported in 575 pregnancies with postpartum follow-up (2.3%; 95% 0.9-4.3; I 2 41.3%), 4,6,7,14,15,[18][19][20][21][23][24][25][26][27][28][29][30][31] comprised of 7 postpartum hemorrhages, 2 hematomas post-cesarean section, and 2 episodes of bleeding after pregnancy loss. Bleeding outcomes with and without LMWH prophylaxis in the antepartum and postpartum periods are presented in Table 2.…”