Diseases of the blood and pregnancy: consequences. How to treat

Hemoblastosis



Blasts are the medical term for tumors, hemoblastosis is the accumulation of neoplasms in blood cells. Infection of lymph nodes and tumor cells leads to the development of diseases: leukemia in acute or chronic form, lymphoma of Nekhodzhkin, imphogranulomatosis.

Myeloblastny and lymphoblastic leukemia in the acute phase develop due to tumor damage to the tissues of the hematopoiesis system. Blast cells at the stage of immaturity gradually spread to the bone marrow, but do not differentiate into blood cells.

The onset of pregnancy is possible with lymphatic leukemia with an acute course. This phenomenon is rare, it does not develop immediately. In most cases, the disease has a prolonged course, but it is with the onset of pregnancy that it is in the stage of stable remission. The most common in pregnant women is acute myelogenous leukemia. It is at this time that, as a result of hormonal failure, the malady begins to manifest.

The reasons for the development of this disease are not fully understood. To cause mutations in cells according to the assumptions of doctors is heredity (genes), intoxication of the organism (poisoning) with chemicals, harmful reagents, radiation (ions).

The differential diagnosis of lymphoblastic and myeloblastic leukemia is based on a cytological and morphological study by taking a puncture from the bone marrow, a blood test for detecting cancer cells.

Pregnancy and the postpartum period can only exacerbate the situation, activate leukocyte cells that were previously in the stage of stable remission, worsen the condition of the woman, adversely affect the course of the entire pregnancy. The prognosis is unfavorable, it is fraught with the death rate of the mother immediately after childbirth. In most cases, the pregnancy ends with spontaneous abortion at an early age, miscarriage or mortality of infants during the perinatal period. Premature births with serious pathologies in the development of the fetus, or death during passage through the birth can occur, often with the mother.

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Hodgkin's disease, lymphogranulomatosis



Disease affects women of childbearing age, much more often than leukemia, is diagnosed during pregnancy. The site of localization of the hemoblast is bone marrow, lymphoid tissue or lymph nodes.

The causes of the pathogenesis of such neoplasms are not fully understood. Granulomas with fairly large mononuclear or specific Hodgkin cells affect the lymph nodes, leading to impaired immunity at the cellular level.

According to the classification, lymphogranulomatosis is divided into stages and subgroups, taking into account the degree of lesion, the site of localization, the number of nodes, the symptomatology in the course of the disease. There are 4 stages of the course of lymphogranulomatosis:

  • at one stage one node or group of nodes
  • is affected.
  • at the second stage several groups of nodes are affected, but on the one hand with respect to the diaphragm

  • in the third stage, cancer cells were found on both sides of the diaphragm, also in the region of the spleen, above the diaphragm

  • at the fourth stage, not only lymph nodes are infected by tumor cells, but the spread has spread to the liver, lungs, kidneys, bone marrow.


  • At each stage, symptoms may be absent altogether. The disease is classified as subgroup A or in subgroup B with a steady rise in temperature to critical markers, increased sweating in the patient at night, and a weight loss of more than 10-15% in 6-8 months.

    Lymphogranulomatosis is diagnosed by carrying out a method of histology, revealing pathogenic cells of the Berezovsky-Sternberg. The disease occurs in pregnant women, but the doctors did not noticeably influence each other on both facts. Although in any case, cancer cells due to rapid spreading require immediate removal through the passage of patients with chemo-radiotherapy. A successful outcome of pregnancy is possible only with stable remission of the disease, or complete cure for it.

    If the lymphogranulomatosis is detected for the first time in the early pregnancy, or the ailment has begun its progress, then women up to 12 weeks will be offered to terminate the pregnancy. If the disease is revealed after 22 weeks, but the general state of health of a woman at the moment is quite satisfactory, then prolongation of pregnancy and normal passage of labor are possible. Treatment begins later, in the construction period. Childbirth is performed naturally in the usual way, but lactation is impossible regardless of whether the disease recurs or is in remission.

    Lymphogranulomatosis does not pass by inheritance and babies are born completely healthy, without abnormal abnormalities. There is no delay in further development.

    Thrombocytopenia



    The disease is diagnosed with a significant decrease in the level of blood platelets on the periphery. The mark does not exceed 150/109. This is due to the destruction of most of the red blood cells or partial cessation of their production.

    As a rule, this disease - acquired, develops due to the development of an autoimmune process in blood cells or long-term use of drugs from cancer, estrogens, thiazide diuretics, ethanol, heparin, sulfamethoxazole. If at the time of pregnancy tromobocytopenia occurs in a moderate form, is not prone to progression and the platelet counts in the blood are stable, then the pregnancy proceeds quite normal, does not lead to special complications either in the mother or in the baby.

    Clinically, purulent disease is the most pronounced thrombocytopenic in the chronic phase. This is a disease of immunity. It occurs in women of reproductive age, progresses with the onset of pregnancy. The pathogenesis of the disease consists in the production of antibodies of platelet origin. When exposed to platelets, it eliminates from blood cells, destructively affecting the spleen.

    The disease usually begins its development long before the onset of pregnancy. Diagnosed by the results of the collected anamnesis, the study of the causes that led to the development of this disease. In the blood, instead of platelets, there are many antiplatelet antibodies. Pregnancy for the development of idiopathic thrombocytopenia does not have a special effect, but progression and exacerbation, as well as bleeding in later terms, are possible against the backdrop of immunity failure, although there is no threat to life. It is pregnancy that contributes to the onset of a stable remission.

    Thrombocytopathy



    The disease is diagnosed when there are violations in the hemostasis, inferiority, platelet dysfunction, while their amount in the blood corresponds to the norm. Sometimes the level is only slightly reduced. With this disease, the properties of platelets are violated, the hemorrhagic syndrome does not correspond to their number. On the periphery of the blood may reveal additional hereditary defects.

    Violation of hemostasis with thrombocytopenia can be hereditary or acquired. In the first case, congenital anomalies lead to impaired platelet function. This form of pathology - disaggregation, blood cells have a platelet deficiency, while the adhesion and aggregation properties of them are not violated. In the second case, with acquired thrombocytopenia, hemoblasts are detected in the blood, anemia with B12 deficiency, uremia, chronic hepatitis, cirrhosis of the liver, fibrinolysis is activated. The outcome at detection of the disease during pregnancy is quite normal. Throughout the time the woman is under the supervision of a doctor, the delivery is natural, but severe bleeding is possible.

    The development of the disease contributes to a decrease in the level of platelet aggregation, dysfunction due to a decline in the estrogenic background, excessive intake of certain medications. Treatment is aimed at eliminating the existing symptoms. Perhaps the appointment of a physician Riboxin B, magnesium sulfate, ATP, aminocaproic acid. With severe bleeding with a threat to the life of women, it is possible to administer a concentrate of artificial platelets. In emergency cases, extirpation of the uterus is prescribed, as the only safe way to stop heavy bleeding. As replacement therapy, blood products with normal platelets are prescribed. If their functional properties are isolated, then correction during pregnancy is not carried out.

    In children born with thrombocytopathy, manifestations of hemorrhagic diathesis are possible. In any case, immediately after birth, a hematological examination of babies is carried out.