Polycythemia Vera and Pregnancy: A Case Report with the Use of Hydroxyurea in the First Trimester

Polycythemia vera (PV) is rarely associated with pregnancy. A 34-year-old patient treated with hydroxyurea for PV became pregnant and was referred to our clinic. At the patient's request, pregnancy was continued. The patient's hematocrit level remained below 45% without any treatment throughout her pregnancy, and a healthy male infant (without any congenital malformations or complications) was delivered at 37 weeks. This case report suggests that normal pregnancy and delivery is possible in patients with PV.

KEYWORDS

Polycythemia vera - pregnancy - hydroxyurea - teratogeny

REFERENCES

• 1 Tefferi A, Solberg L A, Silverstein M N. A clinical up date in polycythemia vera and essential thrombocythemia.  Am J Med. 2000;  109 141-149
• 2 Frezzato M, Ruggeri M, Castaman G, Rodeghiero F. Polycythemia vera and essential thrombocythemia in young patients.  Haematologica. 1993;  78(suppl 2) 11-17
• 3 Ferguson J E, Ueland K, Aronson W J. Polycythemia rubra vera and pregnancy.  Obstet Gynecol. 1983;  62(suppl) 16S-20S
• 4 Griesshammer M, Bergmann L, Pearson T. Fertility, pregnancy and the management of myeloproliferative disorders.  Baillieres Clin Haematol. 1998;  11 859-874
• 5 Crowley J P, Barcohana Y, Sturner W Q. Disseminated intravascular coagulation following first trimester abortion in polycythemia vera. Increased platelet count apparently contributed to fatal outcome.  R I Med J. 1987;  70 109-112
• 6 Schmitt H J, Becke K, Neidhart B. Epidural anesthesia for cesarean delivery in patient with polycythemia rubra vera and preeclampsia.  Anesth Analg. 2001;  92 1535-1537
• 7 Subtill D, Deruelle P, Trillot N, Jude B. Preclinical phase of polycythemia vera in pregnancy.  Obstet Gynecol. 2001;  98(5 pt 2) 945-947
• 8 Ruggeri M, Tosetto A, Castaman G, Rodeghiero F. Pulmonary embolism after pregnancy in a patient with polycythemia vera.  Am J Hematol. 2001;  67 216-217
• 9 Kupferminc M J, Eldor A, Steinman N et al.. Increased frequency of genetic thrombophilia in women with complications of pregnancy.  N Engl J Med. 1999;  340 9-13
• 10 Jackson N, Shukri A, Ali K. Hydroxyurea treatment for chronic myeloid leukemia during pregnancy.  Br J Haematol. 1993;  85 203-204
• 11 Asano Y, Okaniwa A. In utero morphological effects of hydroxyurea on the fetal development in Sprague-Dawley rats.  Jikken Dobutsu. 1987;  36 143-149
• 12 Celiloglu M, Altınyurt S, Undar B. Hydroxyurea treatment for chronic myeloid leukemia during pregnancy.  Acta Obstet Gynecol Scand. 2000;  79 803-804
• 13 Fadilah S A, Ahmad-Zailani H, Soon-Keng C, Norlaila M. Successful treatment of chronic myeloid leukemia during pregnancy with hydroxyurea.  Leukemia. 2002;  16 1202-1203
• 14 Thauvin-Robinet C, Maingueneau C, Robert E et al.. Exposure to hydroxyurea during pregnancy: a case series.  Leukemia. 2001;  15 1309-1311
• 15 Baykal C, Zengin N, Coskun F, Guler N, Ayhan A. Use of hydroxyurea and alpha-interferon in chronic myeloid leukemia during pregnancy: a case report.  Eur J Gynaecol Oncol. 2000;  21 89-90