Pyruvate kinase deficiency complicating pregnancy.
BACKGROUND
Pyruvate kinase deficiency is the second-most common hereditary nonspherocytic hemolytic anemia. Only four affected patients' pregnancies have been reported since 1980.


METHODS
A 22-year-old without prior splenectomy experienced severe hemolytic anemia, with hematocrit as low as 19.0%, requiring serial transfusions. She developed preeclampsia at term and was delivered by cesarean for a nonreassuring fetal heart rate. Another patient with a splenectomy experienced chronic low-grade hemolysis, with the hematocrit ranging from 26.4-31.6%, not requiring transfusion. She delivered vaginally at term after labor induction for fetal growth restriction.


CONCLUSIONS
Despite contrasting maternal courses, preeclampsia, nonreassuring fetal heart rate patterns, and fetal growth restriction, pyruvate kinase deficiency is associated with good maternal-fetal outcomes.
Wax
Joseph R
JR
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, Maine 04102, USA. waxj@mmc.org
Pinette
Michael G
MG
Cartin
Angelina
A
Blackstone
Jacquelyn
J
D000328:Adult; D000743:Anemia, Hemolytic / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D001803:Blood Transfusion; D002585:Cesarean Section; D003937:Diagnosis, Differential; D005260:Female; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000175:diagnosis*; D011296:Prenatal Diagnosis; D011770:Pyruvate Kinase / Q000172:deficiency*
D011770:Pyruvate Kinase