Pregnancy-associated aplastic anemia: Case report
Gebelikte aplastik anemi yüksek mortalite ve morbidite oranlarına sahip ender bir durumdur. Tedavinin temelini gebelik süresi boyunca uygulanan yoğun hematolojik destek oluşturmaktadır. Başarılı bir obstetrik sonuç en iyi şekilde obstetrisyen ve hematoloğun klinik işbirliği ile gerçekleştirilebilir. Bu yazıda orta ciddi aplastik anemisi olup, gebeliği süresince ayda bir kez tekrarlanan yoğun hematolojik destekle tedavi edilen bir hasta sunulmaktadır. Hasta sezaryen ile sağlıklı bir çocuk doğurmuştur.
Gebelikle ilişkili bir aplastik anemi olgusu
Aplastic anemia in pregnancy is a rare condition with high maternal morbidity and mortality rates. Intensive hematological support during antenatal course remains the mainstay of the therapy. A successful obstetric outcome can be best accomplished with the clinical collaboration of the obstetrician and the hematologist. We present a patient with moderately severe aplastic anemia who was managed with intensive hematological support given repeatedly once in a month during pregnancy. She delivered a healthy infant by cesarean section.
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- 1) Leong KW, Teh A, Bosco JJ, Lim J. Successful pregnancy following aplastic anaemia. Postgrad Med J 1995;71:625-7.
- 2) Deka D, Banerjee N, Roy KK, Choudhary VP, Kashyap R, Takkar D. Aplastic anaemia during pregnancy: variable clinical course and outcome. Eur J Obstet Gynecol Reprod Biol 2001;94:152-4.
- 3) Suda T, Omine M, Tsuchiya J, Maekawa T. Prognostic aspects of aplastic anemia in pregnancy. Experience on six cases and review of the literature. Blut 1978;36:285-98.
- 4) Aitchison RG, Marsh JC, Hows JM, Russell NH, Gordon-Smith EC. Pregnancy associated aplastic anaemia: a report of five cases and review of current management. Br J Haematol 1989;73:541-5.
- 5) Huter O, Brezinka C, Schiller L, Schwaighofer H, Nachbaur D, Niederwieser D. Successful treatment of pregnancy-associated severe aplastic anemia by immunosuppression: a case report and review of the literature. J Matern Fetal Invest 1996;6:175-8.
- 6) Calhoun DA, Rosa C, Christensen RD. Transplacental passage of recombinant human granulocyte colony-stimulating factor in women with an imminent preterm delivery. Am J Obstet Gynecol 1996;174:1306-11.
- 7) Kaufmann SJ, Sharif K, Sharma V, McVerry BA. Term delivery in a woman with severe congenital neutropenia, treated with growth colony stimulating factor. Hum Reprod 1998;13:498-9.
- 8) Ohba T, Yoshimura T, Araki M, Miyoshi J, Yonemura Y, Matsuura K, et al. Aplastic anemia in pregnancy: treatment with cyclosporine and granulocyte-colony stimulating factor. Acta Obstet Gynecol Scand 1999;78:458-61.
- 9) Kwon JY, Lee Y, Shin JC, Lee JW, Rha JG, Kim SP. Supportive management of pregnancy-associated aplastic anemia. Int J Gynaecol Obstet 2006;95:115-20.
- 10) Işık N, Ağaçfidan A. İnsan parvovirus B19 infeksiyonlarının tanısında kullanılan moleküler biyoloji yöntemleri. Türk Mikrobiyol Cem Derg 2003;33:377-80.
- 11) Valeur-Jensen AK, Pedersen CB, Westergaard T, Jensen IP, Lebech M, Andersen PK, et al. Risk factors for parvovirus B19 infection in pregnancy. JAMA 1999;281:1099-105.
- 12) Centers for Disease Control (CDC). Risks associated with human parvovirus B19 infection. MMWR Morb Mortal Wkly Rep 1989;38:81-8, 93-7.