H?matologische Erkrankungen in der Schwangerschaft

The management of hematologic disorders in pregnancy presents diagnostic and therapeutic challenges requiring a multidisciplinary approach. Iron deficiency is the most common cause of anemia in pregnancy. Gestational thrombocytopenia is defined by mild, asymptomatic thrombocytopenia and usually requires no therapy. Autoantibody-induced idiopathic thrombocytopenia is treated with steroids and high-dose immunoglobulins in patients with platelet counts below 30,000/??l during pregnancy and below 50,000/??l before delivery. The most common hematologic neoplasias in pregnancy include Hodgkin??s disease, aggressive non-Hodgkin??s lymphomas, and acute leukemias. Cure for the mother depends on consistent intensive chemotherapy. Chemotherapy can be administered during the second and third trimester with reasonable safety, though there is an increased fetal risk. It is important to balance the potential fetal risk against the maternal risk of an untreated neoplasia.