viernes, 7 de diciembre de 2012

TROMBOCITOSIS Y EMBARAZO.

Paciente con trombocitosis esencial que me comenta riesgos
posibilidades de embarazo.Lo ha comentado con hematología que le
desaconseja por el riesgo.
Reviso el tema poco publicado y encuentro revisión en Orphanet muy buena.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781427/
En resumen:
Maternal and fetal risk in pregnancy with ET
Maternal risk is limited. The increased risk of thrombosis (present in
healthy pregnant women as well) may be worsened by ET. Hemorrhagic
risk is low, except in patients with acquired Von Willebrand's disease
[4]. The fetus seems to be at greater risks. There is an overall
increased incidence of first trimester miscarriage in one out of three
pregnancies. Late pregnancy loss is far more frequently observed in ET
than in normal population (5?9.6% vs. 0.5%). An increased incidence of
intrauterine growth retardation (4?5.1%), preterm delivery (5.6?8%)
and placental abruption (2.8%) was reported. Placental
micro-infarctions due to increased platelet number and to platelet
activation seem to be the underlying pathological basis of adverse
events for the fetus. Overall live birth rate may be as low as 50 to
57% [5]. A spontaneous decrease in the number of platelets is
frequently observed, beginning after the first trimester of pregnancy.


Manuel Sánchez mollá
Cap El Raval. Elx
msanchezmolla@coma.es
http://www.metgedelravalelx.blogspot.com
sanchez_manmol@gva.es



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