Elliott Michelle A, Tefferi Ayalew
Department of Hematology and Internal Medicine, Section of Scientific Publications, Mayo Clinic and Mayo Foundation, Mayo Medical School, 200 First Street SW, Rochester, MN 55905, USA.
Best Pract Res Clin Haematol. 2003 Jun;16(2):227-42. doi: 10.1016/s1521-6926(03)00019-7.
The diagnosis of essential thrombocythaemia (ET) is considered when all causes of reactive (secondary) thrombocytosis have been excluded in a patient with a persistent thrombocytosis. Among the chronic myeloproliferative disorders, ET has the highest proportion of young as well as female patients affected. As such, the optimal management of ET during pregnancy becomes an important issue. Although ET is not a contraindication to childbearing, the risks to both the fetus and mother are increased, and would-be-parents should be counselled regarding these. Obstetric complications occurring at higher than expected rates include spontaneous abortion in the first-trimester. Maternal complications, both haemorrhagic and thrombotic, are reported relatively infrequently. It is generally difficult to make specific management recommendations because of the relative rarity of the association between ET and pregnancy, which has precluded adequately powered controlled trials. In this communication, we review our own experience as well as that of other investigators on the subject matter and provide management guidelines that are based on best available information.
当排除了持续性血小板增多症患者所有反应性（继发性）血小板增多的病因后，即可考虑诊断原发性血小板增多症（ET）。在慢性骨髓增殖性疾病中，ET累及的年轻患者以及女性患者比例最高。因此，ET在妊娠期的最佳管理成为一个重要问题。虽然ET并非生育的禁忌症，但胎儿和母亲的风险都会增加，应就此向准父母提供咨询。发生率高于预期的产科并发症包括孕早期自然流产。孕产妇出血和血栓形成并发症的报告相对较少。由于ET与妊娠之间的关联相对罕见，难以进行有足够效力的对照试验，因此通常很难提出具体的管理建议。在本交流中，我们回顾了我们自己以及其他研究者在该主题上的经验，并根据现有最佳信息提供管理指南。
