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Review
. 2018 Feb 28:10:117-125.
doi: 10.2147/IJWH.S149683. eCollection 2018.

Aplastic anemia during pregnancy: a review of obstetric and anesthetic considerations

Efrain Riveros-Perez  1 , Amy C Hermesch  2 , Linda A Barbour  3 , Joy L Hawkins  4
Affiliations
Review

Aplastic anemia during pregnancy: a review of obstetric and anesthetic considerations

Efrain Riveros-Perez et al. Int J Womens Health. .

Abstract

Aplastic anemia is a hematologic condition occasionally presenting during pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management is challenging, and treatment requires a coordinated effort by an interdisciplinary team, in order to provide safe care to these patients. In this review, we describe the current state of the literature as it applies to the complexity of aplastic anemia in pregnancy, focusing on pathophysiologic aspects of the disease in pregnancy, as well as relevant obstetric and anesthetic considerations necessary to treat this challenging problem. A multidisciplinary-team approach to the management of aplastic anemia in pregnancy is necessary to coordinate prenatal care, optimize maternofetal outcomes, and plan peripartum interventions. Conservative transfusion management is critical to prevent alloimmunization. Although a safe threshold-platelet count for neuraxial anesthesia has not been established, selection of anesthetic technique must be evaluated on a case-to-case basis.

Keywords: aplastic anemia; high-risk obstetrics; obstetric anesthesia; platelets; pregnancy.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Pathophysiologic mechanisms of aplastic anemia. Abbreviation: HLA, human leukocyte antigen.
See this image and copyright information in PMC

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