[Chronic myeloproliferative diseases and pregnancy].
OBJECTIVE
To analyse the course of pregnancy in chronic myeloproliferative diseases (CMPD) with hyperthrombocytosis, primarily, essential thrombocytemia.


METHODS
The analysis of thrombogenic risk factors covered literature data and 8 cases observed by the authors.


RESULTS
Six pregnant women received long-term treatment with preparations of interferon-alpha in a dose 9-20 million IU a week (both before and during pregnancy). Rapid reduction of hyperthrombocytosis (1100-4000 x 10(9) l) and the absence of a negative effect on development of the fetus were seen in all the cases. Normal delivery on week 37-39 was in 4 patients, spontaneous abortion on week 24 was provoked by a car accident. Three gravidas (gestational week 28, 33 and 34) are still under observation. Lupus anticoagulant or elevation of anticardiolipin antibodies level was detected in 4 of 8 patients, 2 patients had heterozygous mutation of methylentetrahydrofolatereductase genes and factor V (Leiden). These patients were given lannacher, faxiparine, folic acid and discrete plasmapheresis (in 2 cases).


CONCLUSIONS
Gravidas with hyperthrombocytosis, if not contraindicated, must be treated with aspirin and interferon-alpha preparations at any gestational term. Moreover, it is necessary to exclude additional most prevalent causes of thrombophilia for adequate prevention of thromboses.
Tsvetaeva
N V
NV
Khoroshko
N D
ND
Sokolova
M A
MA
Shmakov
R V
RV
Semenova
E A
EA
Lopukhin
O V
OV
Romanova
E A
EA
Sudarikov
A V
AV
Vasil'ev
S A
SA
Orel
E B
EB
Rudakova
E   A
E
Ivanova
V L
VL
Serebrianaia
L A
LA
Sedova
G T
GT
Manakova
T E
TE
Tutaeva
V V
VV
Levina
A A
AA
Mamukova
Iu I
IuI
D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D009196:Myeloproliferative Disorders / Q000453:epidemiology* / Q000276:immunology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology*; D013922:Thrombocytosis / Q000453:epidemiology; D019851:Thrombophilia / Q000453:epidemiology; D014841:von Willebrand Factor / Q000276:immunology
D014841:von Willebrand Factor