The Clinico-Hematological assessment and feto-maternal outcome of pancytopenia during pregnancy

Introduction: Pancytopenia is defined as decrease in all three cellular elements of peripheral blood leading to anemia, leucopenia and thrombocytopenia1.Pancytopenia usually presents with symptoms of bone marrow failure such as pallor, dyspnea, and bleeding, bruising and increased tendency to infections2. 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%).3 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.4,5 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 into the study with sample size of 96. Written informed consent was taken and study design 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 cheilosis. Platelet count of 30 % of subjects were in the range of 71000 to 90000. 32.3 % mothers had megaloblastic anaemia, Aplastic anaemia was present in 18.7 % and pregnancy induced hypertension in 14.7 % subjects, and eclampsia in 5.2 % subjects. Conclusion: Association of pancytopenia with pregnancy is a rare entity yet it has increased risk of adverse maternal and foetal outcome. Early diagnosis and intervention bring favourable maternal and foetal outcome. This study identified the risk factors of mortality and morbidity in pregnant women with severe aplastic anaemia as well as the obstetrical complications associated with neonatal outcome. Key words: AA-Aplastic anaemia