Hematologic disorders in pregnancy:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, PA
Saunders
2011
|
| Schriftenreihe: | Hematology, oncology clinics of North America
25,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIV S., S. 241 - 455 Ill., graph. Darst. |
| ISBN: | 9781455704590 |
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Datensatz im Suchindex
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| adam_text | Titel: Hematologic disorders in pregnancy
Autor: Connors, Jean M.
Jahr: 2011
Hematologic Disorders in Pregnancy
Contents
Preface xiii
Jean M. Connors
Anemia in Pregnancy 241
Alfred Ian Lee and Maureen M. Okam
Anemia in pregnancy is a global health problem affecting nearly half of all
pregnant women worldwide. High fetal demands for iron render iron defi-
ciency the most common cause of anemia of pregnancy, with other micro-
nutrient deficiencies contributing less frequently. In certain geographical
populations, human pathogens such as hookworm, malarial parasite and
human immunodeficiency virus are important factors in anemia of preg-
nancy. The hemoglobinopathies, sickle cell disease and thalassemia, rep-
resent diverse causes of anemia of pregnancy, requiring specialized care.
Aplastic anemia is a rare, morbid cause of anemia of pregnancy and is
managed with transfusions until the completion of pregnancy.
Myeloproliferative Disorders in Pregnancy 261
Claire N. Harrison and Susan E. Robinson
This article reviews pregnancy outcome in women diagnosed with a mye-
loproliferative neoplasm (MPN), and discusses possible risk markers and
the pathogenesis of poor pregnancy outcome. An outline of the key factors
regarding the diagnosis and management of MPN in women of reproduc-
tive potential is followed by a description of the authors management
strategy for standard and high-risk pregnancy in MPN patients.
Leukemia and Lymphoma in Pregnancy 277
Uri Abadi, Gideon Koren, and Michael Lishner
Treatment of pregnant women with chemotherapy may pose a risk to the
fetus, raising therapeutic, ethical, moral, and social dilemmas. Publica-
tions on this issue are limited to retrospective series and case reports,
thus further complicating decision making. Diagnosis and staging are usu-
ally performed as in nonpregnant women, but procedures that expose the
fetus to radiation are excluded. Chemotherapy is not recommended in the
first trimester to avoid fetal malformations. Thus, the option is either treat-
ment delay or pregnancy termination. Later in pregnancy, treatment is
often initiated without delay, with no apparent evidence of teratogenicity.
Thrombocytopenia in Pregnancy 293
Paula L. Bockenstedt
Thrombocytopenia in pregnancy is most frequently a benign process that
does not require intervention. However, 35% of cases of thrombocytope-
nia in pregnancy are related to disease processes that may have serious
bleeding consequences at delivery or for which thrombocytopenia may
be an indicator of a more severe systemic disorder requiring emergent
Contents
maternal and fetal care. Thus, all pregnant women with platelet counts less
than 100,000/nL require careful hematological and obstetric consultation
to exclude more serious disorders.
Microangiopathic Disorders in Pregnancy 311
Salley G. Pels and Michael J. Paidas
Microangiopathic disorders present with thrombocytopenia, hemolytic
anemia, and multiorgan damage. In pregnancy, these disorders present
a challenge both diagnostically and therapeutically, with widely overlap-
ping clinical scenarios and disparate treatments. Although rare, a clear
understanding of these diseases is important because devastating mater-
nal and fetal outcomes may ensue if there is misdiagnosis and improper
treatment. Microangiopathic disorders presenting in pregnancy are thus
best assessed and treated by both obstetric and hematology teams. As
a better understanding of the pathophysiology underlying each of the
disease processes is gained, new diagnostic testing and therapies will
be available, which will lead to improved outcomes.
Thrombophilias in Pregnancy 323
E.M. Battinelli and K.A. Bauer
Thrombophilic conditions are associated with an increased risk of venous
thromboembolic events (VTE) during pregnancy. Thrombophilic disorders
are either acquired, as in antiphospholipid syndrome, or inherited, as in
factor V Leiden. Both are associated with VTE but acquired disorders
can also increase the risk of arterial events. However, there is controversy
as to whether they may adversely affect other pregnancy outcomes includ-
ing pregnancy loss, placental abruption, severe preeclampsia, and still-
birth. This article discusses the effect of thrombophilias on pregnancy.
Von Willebrand Disease in Pregnancy 335
Brea C. Lipe, Maura A. Dumas, and Deborah L. Ornstein
Because von Willebrand factor (VWF) levels increase during pregnancy,
many women with VWD, though not requiring support with hemostatic
agents, are at increased risk for delayed postpartum hemorrhage as coag-
ulation factor levels fall to their prepregnancy levels in the Puerperium.
Women with moderate or severe disease or complicated pregnancies
are best served by delivering at a center with an obstetrician, hematologist,
and anesthesiologist experienced in managing coagulation disorders. In
addition, on-site laboratory facilities with specialized coagulation testing
capability, pharmacy, and blood bank support are critical for success.
Ensuring optimal outcomes for pregnant women with VWD requires
a multidisciplinary approach.
Factor Deficiencies in Pregnancy 359
Gillian N. Pike and Paula H.B. Bolton-Maggs
Pregnancy, childbirth, and the Puerperium are hemostatically challenging
to women with bleeding disorders. This article provides general recommen-
dations for the management of pregnant women with inherited coagulation
disorders. Each factor deficiency is discussed, providing an up-to-date
review of the literature and, where possible, guidance about how to manage
Contents
patients throughout pregnancy, delivery, and the Puerperium. The factor
deficiencies covered are inherited abnormalities of fibrinogen; deficiencies
of prothrombin, factor (F)V, FVII, FX, FXI, FXIII; combined deficiencies of FV
and FVIII; and the inherited deficiency of vitamin K-dependent clotting fac-
tors. The management of carriers of hemophilia A and B is also discussed.
Treating Venous Thromboembolism in Pregnancy 379
Annemarie E. Fogerty and Jean M. Connors
This review summarizes the currently available data concerning risk, diag-
nosis, and management of venous thromboembolism (VTE) in pregnant
women. While the actual incidence of VTE in pregnancy remains low, the
hypercoagulable state and increased risk requires clinicians to be aware
of the specific aspects of presentation, diagnosis, and treatment in this
population. The authors outline the strategies, efficacy, and safety of the
diagnostic approach, as well as the available data concerning treatment.
Considerations in treatment include maternal and fetal bleeding risk, as
well as management of labor and delivery. The optimal approach to treat-
ment requires collaboration between obstetrics, hematology, and
anesthesia.
Transfusion Medicine and the Pregnant Patient 393
Alfred Ian Lee and Richard M. Kaufman
Alloimmunity in pregnancy is the basis for two of the major complications
of pregnancy in transfusion medicine: hemolytic disease of the fetus and
newborn (HDFN), and fetal and neonatal alloimmune thrombocytopenia
(FNAIT). Use of Rh(D) immune globulin has dramatically reduced the inci-
dence of HDFN in Rh(D)-mismatched pregnancies. Treatment of HDFN
may involve intrauterine transfusion, with fetal and neonatal survival rates
of 70% to 90%. Treatments for FNAIT include immune globulin, steroids,
or in severe cases, intrauterine platelet transfusions. Transfusion medicine
is central to the management of pregnancy-associated complications
such as postpartum hemorrhage, parvovirus B19 infection, hemoglobin-
opathies, and aplastic anemia.
Hematologic Disease in Pregnancy: The Obstetrician s Perspective 415
Nicole A. Smith and Katherine E. Economy
Pregnancy can be a time of significantly increased morbidity and mortality
in women with hematologic disease. With careful planning and prepara-
tion, most women can be cared for safely, resulting in a healthy mother
and child. Management concerns in each trimester are reviewed, with
a particular focus on labor and delivery planning and common obstetric
complications. Diagnostic testing and the use of medications in pregnancy
and lactation are discussed in detail.
Anesthesia in the Pregnant Patient with Hematologic Disorders 425
Lorraine Chow, Michaela K. Färber, and William R. Camann
The management of patients with hematologic disorders in pregnancy
involves a multidisciplinar/ approach involving specialists from hematol-
ogy, obstetrics, and anesthesiology. Whereas regional anesthesia has led
Contents
to a decline in maternal morbidity and mortality, the presence of uncor-
rected coagulopathy or the use of anticoagulant or antithrombotic medica-
tions pose a special risk for the rare complication of an epidural hematoma
after neuraxial anesthesia. This article briefly reviews the common princi-
ples of anesthesia for obstetric patients, provides an obstetric anesthesio-
logist s perspective on the implications of regional anesthesia in obstetrics,
and enhances communication between the specialties.
Index 445
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| spelling | Hematologic disorders in pregnancy guest ed. Jean M. Connors Philadelphia, PA Saunders 2011 XIV S., S. 241 - 455 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Hematology, oncology clinics of North America 25,2 Blutkrankheit (DE-588)4007281-2 gnd rswk-swf Schwangerschaft (DE-588)4053724-9 gnd rswk-swf Schwangerschaft (DE-588)4053724-9 s Blutkrankheit (DE-588)4007281-2 s DE-604 Connors, Jean M. Sonstige (DE-588)1011828278 oth Hematology, oncology clinics of North America 25,2 (DE-604)BV000625446 25,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=022553013&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Hematologic disorders in pregnancy |
| title_auth | Hematologic disorders in pregnancy |
| title_exact_search | Hematologic disorders in pregnancy |
| title_full | Hematologic disorders in pregnancy guest ed. Jean M. Connors |
| title_fullStr | Hematologic disorders in pregnancy guest ed. Jean M. Connors |
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