title: Pregnancy and Delivery in Patients with Mastocytosis Treated at the Polish Center of the European Competence Network on Mastocytosis (ECNM).
abstract: OBJECTIVE
  To present current guidelines regarding treatment of mastocytosis in pregnancy on the example of observed patients.
  
  
  METHODS
  Case control national study.
  
  
  METHODS
  Polish Center of the European Competence Network on Mastocytosis (ECNM).
  
  
  METHODS
  23 singleton spontaneous pregnancies in 17 women diagnosed with mastocytosis in years 1999-2014, before becoming pregnant.
  
  
  METHODS
  Prospective analysis outcomes of pregnancies and deliveries.
  
  
  METHODS
  Survey developed in cooperation with the Spanish Instituto de Estudios de Mastocitosis de Castilla-La Mancha (CLMast), Hospital Virgen del Valle, Toledo, Red Espańola de Mastocitosis (REMA), Spain.
  
  
  RESULTS
  All 23 pregnancies resulted from natural conception. Obstetrical complications recorded in the first trimester included spontaneous miscarriage (5 pregnancies). Four patients delivered preterm, including one delivery due to preeclampsia at 26 weeks which resulted with neonate death due to extreme prematurity. Five women delivered via cesarean: four due to obstetrical indications and one due to mastocytosis, during which no anesthesia related complications were recorded. Of patients delivering vaginally, two received extradural anesthesia, three required oxytocin infusion due to uterine hypotonia. No labor complications were recorded. In one woman with pregnancy-induced hypertension, early puerperium was complicated by the presence of persistent arterial hypertension. One neonate was born with the signs of cutaneous mastocytosis. Another neonate was diagnosed with Patau syndrome. Four women were treated for mastocytosis prior to conception and continued therapy after becoming pregnant. One patient was put on medications in the first trimester due to worsening of her symptoms. Pregnancy exerted only a slight effect on the intensity and frequency of mastocytosis-related symptoms observed. Worsening of the disease-related symptoms was documented in only four patients (23%). None of the patients showed the signs of anaphylaxis, either before becoming pregnant, or during pregnancy and puerperium.
  
  
  CONCLUSIONS
  There is no contraindication to pregnancy when mastocystosis-related pathologies are under appropriate medical control.
authors.affiliation: Department of Obstetrics, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Ciach
authors.affiliation: Department of Allergology, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Niedoszytko
authors.affiliation: Department of Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Abacjew-Chmylko
authors.affiliation: Department of Obstetrics, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Izabela
authors.initials: I
authors.lastname: Pabin
authors.affiliation: Department of Obstetrics, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Adamski
authors.affiliation: Department of Obstetrics, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Leszczynska
authors.affiliation: Department of Obstetrics, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Preis
authors.affiliation: Department of Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Olszewska
authors.affiliation: Department of Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Dariusz G
authors.initials: DG
authors.lastname: Wydra
authors.affiliation: Department of Physiotherapy, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Rita
authors.initials: R
authors.lastname: Hansdorfer-Korzon
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008415:Mastocytosis / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult