Successful management and perinatal outcome of pregnancy complicated with myelodysplastic syndrome

Abstract 

Pregnancy complicated with myelodysplastic syndrome (MDS) is rare and case management is controversial. We report six cases of MDS that were successfully managed during pregnancy including uneventful transvaginal delivery and satisfactory postpartum clinical prognosis. Two patients with MDS who became pregnant twice had normal uneventful deliveries showing no deterioration of MDS. Our findings suggest that pregnancy should be allowed to full-term in MDS patients, especially those of the refractory anemia type, but strict management should be provided before, during and after pregnancy. Pancytopenia might develop during pregnancy but the likelihood of transformation of MDS to leukemia due to pregnancy is remote.

Keywords: Myelodysplastic syndrome, Refractory anemia, Pregnancy, Vaginal delivery, Management, Outcome

Abbreviations: MDS, myelodysplastic syndrome, RA, refractory anemia, RAEB, RA with excess of blasts, CMML, chronic myelomonocytic leukemia, RAEB-t, RAEB ‘in transformation’, FAB, French–American–British classification, VD, vaginal delivery