title: Obstetric Complications and Management in Chronic Myeloid Leukemia.
abstract: Chronic myeloid leukaemia (CML) is amongst the most common haematological malignancies encountered in adults. The younger age of onset and increased incidence of CML in Indians leads to higher chances of encountering it in pregnancy. Pregnancy in CML is a complex situation as first line therapy with tyrosine kinase inhibitors (TKI), is fraught with multiple fetal safety issues. The fetal aspects have been elucidated in literature, but there is scarcity of information on the obstetric outcome per se in presence of CML, excluding the influence of TKI. Obstetric outcomes of 5 pregnancies in four patients with CML are being reported. Literature on interplay of CML and bleeding or thrombotic manifestations is reviewed. The major complications encountered were antepartum (APH) and postpartum haemorrhage (PPH), preterm labour, intrauterine growth retardation and intrauterine fetal death. Patients in the reproductive age group with diagnosis of CML should be carefully counseled regarding the effect of disease and TKI on the maternal-fetal health. Bleeding complications, particularly APH and PPH may be encountered in CML patients. Close coordination of the obstetrician, haematologist, and neonatologist is required in managing these cases successfully. The need for absolute contraception till the remission of disease needs to be emphasized for further pregnancies.
authors: Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India.
authors: Minakshi
authors: M
authors: Rohilla
authors: Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India.
authors: Rakhi
authors: R
authors: Rai
authors: Department of Hematology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India.
authors: Uday
authors: U
authors: Yanamandra
authors: Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India.
authors: Neelam
authors: N
authors: Chaudhary
authors: Department of Hematology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India.
authors: Pankaj
authors: P
authors: Malhotra
authors: Department of Hematology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India.
authors: Neelam
authors: N
authors: Varma
authors: Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India.
authors: Vanita
authors: V
authors: Jain
authors: Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India.
authors: G R V
authors: GR
authors: Prasad
authors: Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India.
authors: Jasvinder
authors: J
authors: Kalra
authors: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India.
authors: Subhash C
authors: SC
authors: Varma
keywords: Chronic myeloid leukaemia; Haemorrhagic obstetric complications; Pregnancy; Tyrosine kinase inhibitors