妊娠合并骨髓异常增生综合征的产科处理

The Management for Pregnancy Complicated with Myelodysplastic Syndrome

目的探讨妊娠合并骨髓异常增生综合征的发生率、孕产期诊断、治疗和预后。方法回顾性分析1992年1月至1997年12月期间住院分娩的妊娠合并骨髓异常增生综合征6例,并复习文献。结果妊娠合并骨髓异常增生综合征发生率为0.66‰,占女性 MDS 人群的24%。6例中2例因病情严重而终止妊娠;产后出血超过500毫升者3例;合并妊娠高血压综合征2例;因产科指征剖宫产2例。全部患者在孕产期均需输血治疗、终止妊娠前应用激素及产后用抗生素预防感染。结论预防出血和感染是处理的关键。

Objective To investigate the incidence of pregnancy complicated with myelodys- plastic syndrome(MDS)and the influence between pregnancy and MDS and to discuss the diagnosis, treatment and prognosis of pregnancy complicated with MDS.Methods Six pregnant patients complicated with MDS from Jan,1992 to Dec,1997 were retrospectively analysed and literature was reviewed.Results The incidence of pregnancy complicated with MDS was 0.66‰ and 24% of women with MDS were pregnant women.Therapeutic induction of labor was done in 2 cases because of severe MDS.Two complicated with PIH,and three complicated with postpartum haemorrage in six cases.Blood transfusion was necessary in all cases for treatment of severe anemia in pregnancy. MDS may remit after delivery.The use of corticosteroid before termination of pregnancy and prophy- lactic antibiotics after delivery is important.Conclusions It is important to prevent haemorrage and infection in the management of pregnaney complicated with MDS.