Introduction: Pancytopenia is defined as a decrease in all three cellular elements of the peripheral blood, leading to anemia, leucopenia, and thrombocytopenia. Pancytopenia usually presents with symptoms of bone marrow failure such as pallor, dyspnea, and bleeding, bruising, and an increased tendency to infection. The most common causes leading to pancytopenia on bone marrow examination are hypoplastic/aplastic bone marrow (29.05%), megaloblastic anemia (23.64%), hematological malignancies, i.e., acute myeloid leukemia (21.62%), and erythroid hyperplasia (19.6%). The commonest clinical manifestations of pancytopenia are usually fever (86.7%), fatigue (76%), dizziness (64%), weight loss (45.3%), anorexia (37.3%), night sweats (28%), pallor (100%), bleeding (38.7%), and spleenomegaly (48%). A pregnancy complicated by severe AA is a great challenge for obstetricians.
Objective: To assess the clinico-hematological parameters and fetal outcomes among pregnant mothers with pancytopenia.
Methods: Pregnant mothers with pancytopenia visiting ANC OPD or admitted patients were enrolled in the study with a sample size of 96. Written informed consent was obtained, the study design was explained to them, and the investigations were done and data was collected.
Results and discussion: subjects presented with symptoms of pancytopenia like pallor, bleeding diathesis, fatigue and fever, glossitis, and cheilosis. The platelet count of 30 % of subjects was in the range of 71000 to 90000. 32.3% of mothers had megaloblastic anemia; aplastic anaemia was present in 18.7%; pregnancy-induced hypertension in 14.7% of subjects; and eclampsia in 5.2% of subjects.
Conclusion: The association of pancytopenia with pregnancy is a rare entity, yet it has an increased risk of adverse maternal and foetal outcomes. Early diagnosis and intervention lead to favorable maternal and foetal outcomes. This study identified the risk factors for mortality and morbidity in pregnant women with severe aplastic anemia, as well as the obstetrical complications associated with neonatal outcomes.
Key words: AA-Aplastic anaemia
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