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Tekrarlayan Gebelik Kaybı Bulunan Yüksek Riskli Esansiyel Trombositemili Gebede Tedavi

MANAGEMENT OF HIGH RISK ESSENTIAL THROMBOCYTHEMIA IN PREGNANT WITH RECURRENT PREGNANCY LOSS

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Abstract (2. Language): 
Essantial Thrombocythemia (ET) is a disease characterized by an increased platelets count, megakaryocyte hyperplasia and increased thrombotic or hemorrhagic events. ET is frequent in women and 15-20% of patients with ET are diagnosed in childbearing age. Pregnancy loss is more in patients with ET than normal population. Early pregnancy loss occurs in 1/3 of patients with ET. We present a women, with ET complicated with portal vein thrombosis who had 3 early and 1 late pregnancy loss with hydroxyurea treatment. She had live birth after treatment with interferonalfa (IFN-α) and low molecular weight heparin (LMWH). Aims of treatment of pregnant women with ET prevent of maternal complications and pregnancy loss due to vasooclusive events. Thus, treatment with IFN-α, aspirin and LMWH are safe and improve pregnancy outcomes.
Abstract (Original Language): 
Esansiyel trombositemia (ET) tormbositoz, megakaryosit hiperplazisi, kanama veya tombozlar ile karaekterize bir hastalıktır. ET kadınlarda daha sık görülmektedir ve yaklaşık %15-20’sini doğurganlık çağındaki hastalar oluşturmaktadır. ET’li kadınlarda gebelik kayıpları normal popülasyona göre daha sık görülmektedir. Yaklaşık 1/3’ü erken gebelik kayıpları şeklindedir. Hidroksiüre tedavisi altında 3 adet erken gebelik kaybı, 1 adet ölü doğum gerçekleştiren, portal ven trombozu bulunan yüksek riskli bir ET hastasında interferon-alfa (IFN-α) ve düşük moleküler ağırlıklı heparin (DMAH) tedavisi ile miadında sağlıklı, canlı doğum gerçekleştiren bir olgu sunulmuştur. ET’li gebelerde tedavi amacı maternal komplikasyonların ve fetal kayıplara neden olacak vazooklüsiv olayların önlenmesi olmalıdır. Sonuç olarak ta IFN-α, aspirin ve DMAH tedavisi gebelerde güvenli olduğu ve gebelik sonuçlarını olumlu etkilediği görülmektedir.
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