Book of Medical Disorders in Pregnancy - Tintash

Labor/delivery: Expedite for normal
obstetric indications. Ideally when
mother in remission and fetus mature.
Steroids if preterm delivery
contemplated.
Postnatal:
Contraceptive advice, counseling about
long-term prognosis, avoid breastfeeding
if on active cytotoxic treatment) Examination
and follow up of newborn
Chronic granulocytic leukemia:
Pre pregnancy:
Counsel about prognosis both for
pregnancy and in long term. Give
contraceptive advice.
Prenatal:
Regular hematological monitoring
consider leukopheresis, control with
busulphan, hydroxyurea or alpha
interferon (avoid cytotoxics in first
trimester) manage accelerated phase and
blast crisis as for non pregnant patient
and expedite delivery if possible (to
allow possibility of bone marrow
transplantation).
Postnatal:
As for acute leukemia.
REFERENCES
1. Morrison, J.C. Anemia associated with
Pregnancy. In J.J. Sciarra (Ed.)
Gynecology and Obstetrics.
Hagerstown, Md. Harper and Row,
1980. Vol. 3.
2. Dallman, P.R. Inhibition of iron
absorption by certain foods, Am. J.Dis.
child. 134: 453, 1980.
3. Wigton R.S. et al. Chart reminders in
the diagnosis of anemia. J.A.M.A.
245:1745, 1981.
4. Kaneshinge, E. Serum ferritin as an
assessment of iron stores and other
hematogolic parameters during
pregnancy. Obstet. Gynec. 1. 57 :238,
1981.
5. Beisel, W.R.lron nutrition: immunity
and infection. Res. Staff Phys. 54:37,
1981.
17
6. Oxford Handbook of Clinical Medicine,
4th Edition. Hope RA et al. Oxford
University Press 1998.
7. Fundamentals of Obstetrics and
Gynaecology 7th Edition. Llewellyn-
Jones D. Mosby 1999. p130-134.
8. Haslam N, Lock RJ, Unsworth DJ;
Coeliac disease, anaemia and
pregnancy.;Clin Lab 2001;47(9-
10):467-9.[abstract]
9. Juarez-Vazquez J, Bonizzoni E, Scotti
A; Iron plus folate is more effective
than iron alone in the treatment of iron
deficiency anaemia in pregnancy: a
randomised, double blind clinical
trial.;BJOG 2002 Sep;109(9):1009-
14.[abstract]
10. Acknowledgements EMIS is grateful to
doctoronline.nhs.uk for facilitating draft
authoring of this article and To Drs S &
H Huins for their additions. The final
copy has passed peer review of the
independent Mentor GP authoring team.
©EMIS 2004.