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Korean Journal of Obstetrics & Gynecology 2003;46(5):1037-1042.
Published online May 1, 2003.
Acute Leukemia and Myelodysplasitc Syndrome During Pregnancy A Single Institutional Experience of 4 Cases.
Jo Young Kim, Jin Ho Cho, Sung Woon Chang, Hyeon Chul Kim, Suk Ho Kang, Hyung Jun Cho, Kyung Mi Lee, Mi Na Eun, Sang Geun Jung, Yun Ah Kim, So Young Chong, Do Yeun Oh
1Department of Obstetrics and Gynecology, Pochon CHA University Medical College, Bundang, Korea.
2Department of Internal Medicine, Pochon CHA University Medical College, Bundang, Korea.
Abstract
We have reviewed the medical records of 4 pregnant patients with concomitant acute leukemia at our institution in conjunction with determining the delivery process in order to reduce complications associated with the delivery. Of the 4 patients, three cases were diagnosed as acute leukemia and the other as myelodysplastic syndrome. One experienced an incomplete abortion at gestational age of 10 weeks, after remission induction chemotherapy. The remaining three patients made delivery at full term by Cesarean section. Our observation indicated that Cesarean delivery was advisable for these three patients. Most of the patients had thrombocytopenia or anemia. Before the Cesarean section or dilatation or evacuation, transfusion was undertaken to prevent hemorrhage or severe anemia. In the cases of refractoriness to blood transfusion, a greater amount was transfused. After Cesarean section, some complications were reported such as fever, delayed wound repair, and vaginal bleeding. Based on the our observations, we are of the opinion that pregnant women with acute leukemia or myelodysplastic syndrome can be managed even in those cases where the state of leukemia is not in complete remission or chemotherapy-induced cytopenia is. And the proper measures are timely undertaken to prevent complications associated with delivery.
Key Words: Acute leukemia, Myelodysplastic syndrome, Pregnancy, Delivery, Complications
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