妊娠合并骨髓增生异常综合征

Myelodysplastic syndromes in pregnancy

骨髓增生异常综合征是一组由于骨髓克隆性造血干细胞异常及单克隆无效造血,导致患者一系或多系血细胞数目减少的疾病。妊娠合并骨髓增生异常综合征的患者可发生致命性出血、感染或败血症,同时少数患者可能在妊娠期或产后进展为急性白血病,是严重的妊娠合并症。随着骨髓增生异常综合征发病呈年轻化趋势,在对妊娠合并血细胞减少患者的诊治中,应注意骨髓增生异常综合征的排查诊断。本文就妊娠合并骨髓增生异常综合征的诊断、妊娠期与分娩期管理以及预后等问题进行讨论。

Myelodysplastic syndromes（ MDS） is a group of disorders caused by poorly formed or dysfunctional bone marrow hematopoietic stem cells,which lead to low numbers of one or more type of blood cells. Pregnant patients complicated with MDS may result in severe complications,such as fatal hemorrhage,infection and sepsis; in a few patients,MDS can progress to a severe pregnancy outcome called acute myeloid leukemia during pregnancy or in postpartum. As more and younger people present with MDS,more attention should be paid to the differential diagnosis of MDS in pregnant women with cytopenia.In this article, the author discussed the diagnosis, management and prognosis of pregnant patients complicated with MDS.