妊娠合并白血病的孕期监护及分娩决策  

Monitoring and delivery decision-making for pregnancy complicated with leukemia

作　　者：崔俭俭 梅恒[2] 赵茵[1,3] CUI Jianjian;MEI Heng;ZHAO Yin(Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属协和医院妇产科,湖北武汉430030 [2]华中科技大学同济医学院附属协和医院血液科,湖北武汉430030 [3]深圳华中科技大学研究生院,广东深圳518000

出　　处：《中国实用妇科与产科杂志》2022年第12期1178-1182,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金(82171678);深圳市自然科学基金(JCY20200109140614667)。

摘　　要：白血病(leukemia)是常见的造血干细胞恶性克隆性疾病之一,可导致白细胞异常、贫血、血小板减少或者显著升高。而白血病发生于妊娠期临床较为罕见,国外报道的年发病率约为1/(10 000~100 000)。妊娠合并白血病会增加患者在妊娠期和围产期出血、感染、弥散性血管内凝血(DIC)甚至死亡等风险,也增加流产、畸胎、死胎、胎儿生长受限和早产的风险。由于病例数量有限,缺乏大规模的临床研究,国内目前尚无统一的妊娠合并白血病的管理规范和临床共识,这给产科医生带来了极大的挑战。文章在参考国内外文献的基础上,总结妊娠合并白血病的孕期监护及分娩决策,以期为妊娠合并白血病的临床管理提供参考。Leukemia is one of the common malignant clonal diseases of hematopoietic stem cells,which can lead to abnormal white blood cells,anemia,thrombocytopenia or significant increase.Leukemia occurring during pregnancy is relatively rare,and the annual incidence reported abroad is about 1/100,000 to 1/10,000.Leukemia occuring during pregnancy increases the risk of hemorrhage,infection,DIC,even death etc.,during pregnancy and perinatal period,it also increases the risk of miscarriage,teratogenesis,stillbirth,fetal growth restriction,and preterm birth.Due to the limited number of cases and the lack of large-scale clinical studies,there is no unified management guideline or clinical consensus for pregnancy complicated with leukemia in China,which brings great challenges to obstetricians.This article intends to summarize the monitoring and delivery decision-making of pregnancy complicated with leukemia on the basis of referring to domestic and foreign literatures,aiming to provide a reference for the clinical management of pregnancy complicated with leukemia.

关 键 词：妊娠合并白血病 孕期监护 分娩决策 

分 类 号：R714.254[医药卫生—妇产科学]