The Clinical Character And Research Of Pregnancy Complicated With Aplastic Anemia

Pregnancy complicated with Aplastic anemia is a rare and severe complication. On account of its low incidence, the clinical characters has not been clearly known. With the development of diagnosis and treatment in aplastic anemia, its incidence has a trend to increase.Objectives: To study PCAA clinical chracters, to direct how to select treatment, this article study 28 cases diagnosed pregnancy complicated with aplastic anemia from January 2000 to December 2007 retrospectively.Methods: Case control was done to compare PCAA with AA happened in child-bearing period in clinical features, CBC, bone marrow pathology, the variation between before treatment and after treatment. We divid PCAA into onset before pregnancy group and onset during pregnancy group based on the onset of AA and its relationship with pregnancy , CBC, the changes of condition between before and after pregnancy termination.Result: 1. The incidence of hemorrhage in PCAA group (39.29%) is lower than that in AA in child-bearing period group (64%). 2. WBC, MCV, NE% of PCAA group is higher than that of AA in child-bearing period group. However, RBC, Hb, LY% of PCAA is lower than that of AA in child-bearing period group(P<0.05); compare with PCAA and AA in child-bearing period group in bone marrow pathology, the ratio of granulocyte series is higher in PCAA, but erythrocyte series and lymphocyte series is lower in PCAA(P<0.05). 3. After treatment, number of WBC increases and LY% decreases(P<0.05), but in AA in child-bearing period group there is no changes in WBC before and after treatment, LY% increases after treatment. 4. Hb and NE% of onset during pregnancy group is much higher than that of onset before pregnancy group, however, LY% of onset during pregnancy group is much lower than that of onset before pregnancy group. 5. The number of WBC increases and LY% decreases(P<0.05) in onset during pregnancy group after pregnancy termination, while, onset before pregnancy group has not got the same changes. 6. In onset during pregnancy group: 1 in 10 cases of early and mid trimester of pregnancy has finished pregnancy, while, 8 in 9 cases of late trimester of pregnancy have finished pregnancy. In onset before pregnancy group: in 10 cases of early and mid trimester of pregnancy nobody has finished pregnancy, while, only 1 case of late trimester of pregnancy has finished pregnancy.Conclusion: 1 The incidence of hemorrhage in PCAA group is lower than that in AA in child-bearing period group. 2 Erythrocyte series is inhabited more obviously in PCAA group, granulocyte series is inhabited more slightly and LY% is lower in PCAA group. 3 Cases with MCV increasing should be pay attention to in case of misdiagnosis and missed diagnosis. 4 The degree of cases in onset during pregnancy group is lower, response is better. however, The degree of cases in onset before pregnancy group is heavier, response is poorer. 5 In onset during pregnancy group, preganancy has relation to AA. After pregnancy termination, the condition of patients have obviously improved. 6 Pregnancy termination is an effective therapy for cases with onset during pregnancy. 7 WBC,LY% may be sensitive index to evaluate response, but it need to be study furthermore.