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

Efrain Riveros-Perez, Amy C. Hermesch, Linda A. Barbour, Joy L. Hawkins

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)117-125
Number of pages9
JournalInternational Journal of Women's Health
Volume10
DOIs
StatePublished - Feb 28 2018

Keywords

  • Aplastic anemia
  • High-risk obstetrics
  • Obstetric anesthesia
  • Platelets
  • Pregnancy

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology
  • Maternity and Midwifery

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