Therapeutic phlebotomy in antenatal and postnatal period of pregnancy

Kavinkumar G.

doi:10.18203/2320-1770.ijrcog20262570

Authors

Kavinkumar G. Department of Transfusion Medicine, Sri Ramachandra Medicaal College and Research Institute, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20262570

Keywords:

Pregnancy outcomes, Polycythemia in pregnancy, Hematocrit

Abstract

Polycythemia during pregnancy is an uncommon but a high-risk condition that requires careful monitoring and individualized management to prevent maternal and fetal complications. This case report describes a pregnant woman diagnosed with polycythemia in the first trimester, managed successfully with therapeutic venesection under close monitoring. The procedure was well tolerated with no adverse effects on maternal or fetal health, and the pregnancy ended in the delivery of a healthy infant at term. A second venesection was performed postpartum due to persistent elevation of hematocrit. This case illustrates the safety and efficacy of venesection in pregnant patients with polycythemia, emphasizing the importance of multidisciplinary care and regular hematological evaluation throughout the antenatal and postpartum period.

References

Kim KH, Oh KY. Clinical applications of therapeutic phlebotomy. J Blood Med. 2016;18:139-44.

Assi TB, Baz E. Current applications of therapeutic phlebotomy. Blood Transfus. 2014;12(1):75.

Wille K, Bernhardt J, Sadjadian P, Becker T, Kolatzki V, Huenerbein K, et al. The management, outcome, and postpartum disease course of 41 pregnancies in 20 women with polycythemia vera. Eur J Haematol. 2021;107(1):122-8.

Aggarwal N, Chopra S, Suri V, Sikka P, Goundan A, Malhotra P. Polycythemia vera and pregnancy: experience of four pregnancies in a single patient. Arch Gynecol Obstet. 2011;283:393-5.

Subtil D, Deruella P, Trillot N, Jude B Preclinical phase of polycythemia vera in pregnancy. Obstet Gynecol. 2001;98:945-7.

Dilek TU, Oktem M, Yildiz A. Polycythemia vera and pregnancy. Int J Gynecol Obstet. 2004;85(2):161-2.

Robinson S, Bewley S, Hunt BJ, Radia DH, Harrison CN. The management and outcome of 18 pregnancies in women with polycythemia vera. Haematologica. 2005;90:1477-83.

Pata O, Tok CE, Yazici G, Pata C, Oz AU, Aban M, et al. Polycythemia vera and pregnancy: a case report with the use of hydroxyurea in the first trimester. Am J Perinatol. 2004;21(3):135-7.

Griesshammer M, Struve S, Harrison CM. Essential thrombocythemia/polycythemia vera and pregnancy: the need for an observational study in Europe. Semin Thromb Hemost. 2006;32(4):422-9.

Benevolo G, Vassallo F, Urbino I, Giai V. Polycythemia Vera (PV): Update on Emerging Treatment Options. Ther Clin Risk Manag. 2021;16:209-21.