title: Massive postpartum hemorrhage after chemotherapy in a patient with acute promyelocytic leukemia.
abstract: A pregnant woman was diagnosed with acute promyelocytic leukemia at 38 weeks of gestation. Induction of labor was successful, and the patient delivered a healthy male baby. Soon after delivery, she was treated with chemotherapy using all-trans-retinoic acid (ATRA). The number of white blood cells was increased on the fifth postpartum day and retinoic acid syndrome (RAS) was considered a concern. On the sixth postpartum day, remission induction chemotherapy with idarubicin and cytosine arabinoside was started. On the seventh postpartum day, massive uterine bleeding of more than 1300 mL suddenly occurred. As administration of cytotoxic agents may induce disseminated intravascular coagulation, we should take care to avoid uterine bleeding after chemotherapy in acute promyelocytic leukemia cases treated soon after delivery.
authors.affiliation: Department of Obstetrics and Gynecology             Third Department of Internal Medicine, University of Toyama, Toyama, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Aoki
authors.forename: Noriko
authors.initials: N
authors.lastname: Yoneda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoneda
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Miyazono
authors.forename: Toshiro
authors.initials: T
authors.lastname: Sugiyama
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000627:therapeutic use; D060828:Induction Chemotherapy; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications* / Q000188:drug therapy; D006473:Postpartum Hemorrhage / Q000209:etiology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*; D014212:Tretinoin / Q000627:therapeutic use
chemical_list: D003561:Cytarabine; D014212:Tretinoin; D015255:Idarubicin