Smolinsky Adi, Carson Michael P, Guzman Edwin R, Ranzini Angela, Toscano Joanne, Bukhari Amar
Department of Obstetrics and Gynecology , Saint Peter's University Hospital , New Brunswick, NJ , USA.
Department of Medicine , Jersey Shore University Medical Center , Neptune, NJ , USA.
Obstet Med. 2009 Mar;2(1):26-9. doi: 10.1258/om.2008.080035. Epub 2009 Mar 1.
Aplastic anaemia is a rare haematological disorder during pregnancy, which when complicated by severe thrombocytopenia poses a significant maternal risk. A woman with aplastic anaemia and a platelet (PLT) count of 11 × 10(9)/L refractory to PLT transfusion required caesarean delivery. Proactive planning by a multidisciplinary team, large volume PLT transfusion prior to surgery and postoperative uterine artery embolization resulted in avoidance of mortality. Maternal preferences should be discussed in detail due to the high risk of maternal morbidity and mortality associated with severe aplastic anaemia. This report outlines a management plan to address the medical and ethical issues faced when caring for a pregnant patient with severe aplastic anaemia and severe thrombocytopenia. We credit the good outcome to our proactive multidisciplinary approach.
再生障碍性贫血是妊娠期一种罕见的血液系统疾病，当合并严重血小板减少症时会给孕产妇带来重大风险。一名患有再生障碍性贫血且血小板（PLT）计数为11×10⁹/L且对血小板输注无效的女性需要剖宫产。多学科团队的积极规划、术前大量血小板输注以及术后子宫动脉栓塞术避免了死亡。由于严重再生障碍性贫血相关的孕产妇发病和死亡风险很高，应详细讨论产妇的偏好。本报告概述了一项管理计划，以解决照顾患有严重再生障碍性贫血和严重血小板减少症的孕妇时面临的医学和伦理问题。我们将良好的结果归功于积极的多学科方法。
