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02 December 2022, Volume 38 Issue 12 Previous Issue   

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Common etiology and diagnosis of anemia in pregnancy. GENG Hui-zhen, WANG Zi-lian 2022, 38(12): 1156-1159.  DOI: 10.19538/j.fk2022120102 Abstract ( )   Anemia is a common medical comorbidity during pregnancy and seriously threatens the health of mothers and children.Anemia is an important part of prevention and health care during perinatal period because can cause short-term and long-term effects on mother，fetus and newborn.There are a variety of common causes of anemia during pregnancy，among which iron deficiency anemia is the most common，accounting for the vast majority of anemia during pregnancy.In the south of the Changjiang River，thalassemia is also a common cause，while megaloblastic anemia and hemolytic anemia account for a small proportion.The main prevention and treatment method is iron supplementation for iron deficiency anemia.Pregnancy screening is particularly critical because genetic defects of thalassemia seriously affect the health of mothers and children.Therefore，it is of great significance to maternal and child health to improve obstetricians' recognition of the etiology of pregnancy anemia.

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Management and genetic counseling of thalassemia during pregnancy.  LI Li-yan, WANG Zhi-jian 2022, 38(12): 1159-1163.  DOI: 10.19538/j.fk2022120103 Abstract ( )   Thalassemia is one of the most common single-gene genetic diseases in clinical practice and a major public health problem of birth defects in China.Management and genetic counseling of thalassemia during pregnancy is the most critical way for controlling the birth of children with severe thalassemia and reducing the burden on families and society.The management of anemia and intervention of related complications are also essential for thalassemia carriers during pregnancy.

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Prevention and treatment of autoimmune hemolytic anemia in pregnancy. FENG Ling, ZHOU Xuan 2022, 38(12): 1163-1166.  DOI: 10.19538/j.fk2022120104 Abstract ( )   Autoimmune hemolytic anemia（AIHA）is a kind of hemolytic anemia，which is due to the erythroclasis caused by the abnormal immune function of body.Pregnancy with AIHA is uncommon in clinic，so there are not many literature reports，but the acute outset of the disease has a serious effect on the pregnancy outcome.The risk brought to the fetus mainly depends on the ability of its own antibodies to pass through the placenta barrier.Therefore，active prevention and effective treatment of AIHA during pregnancy are of great significance to improving pregnancy outcomes.

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Etiology and differential diagnosis of thrombocytopenia in pregnancy. LI Li-ping, YING Hao 2022, 38(12): 1166-1170.  DOI: 10.19538/j.fk2022120105 Abstract ( )   Thrombocytopenia is a common hematological disease during pregnancy.The etiologies of thrombocytopenia in pregnancy are mainly related to the pregnancy-specific physiological changes or a variety of medical complications.The clinical manifestations and managements will be different according to different etiologies.Clarifying the causes and differential diagnosis of thrombocytopenia in pregnancy is helpful for early diagnosis and individualized treatment of patients with thrombocytopenia in pregnancy，which is also of great significance to strengthen perinatal monitoring and reducing the incidence of adverse pregnancy outcomes.

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Management of primary immune thrombocytopenia during pregnancy. ZHANG Shu-wen, QIAO Chong 2022, 38(12): 1170-1173.  DOI: 10.19538/j.fk2022120106 Abstract ( )   Primary immune thrombocytopenia（ITP）is an acquired autoimmune hemorrhagic disease.The incidence of ITP in adults is about（2-10）/100 000.ITP during pregnancy is a common cause of pregnancy with thrombocytopenia，accounting for about 3%-5%.It is mainly manifested as thrombocytopenia in early pregnancy.The basic principle of the treatment for ITP during pregnancy is preventing maternal and neonatal adverse bleeding events.The first-choice treatment is drug therapy，including glucocorticoids，recombinant human thrombopoietin，etc.The management of ITP during pregnancy must run throughout pregnancy，focusing on pre-conception counseling，monitoring and treatment during pregnancy，selection of delivery timing and mode，and neonatal platelet testing.

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Identification and treatment of gestational thrombocytopenic purpura and hemolytic uremic syndrome. YANG Yong, ZHOU Wei 2022, 38(12): 1173-1177.  DOI: 10.19538/j.fk2022120107 Abstract ( )   Both thrombotic thrombocytopenic purpura（TTP）and hemolytic uremic syndrome（HUS）are classified as thrombotic microangiopathy（TMA），which has the characteristic of acute onset，severe illness and a high mortality.TMAs are relatively rare disease.They are not pregnancy-specific diseases；however，they are clinical rare，and have similar clinical manifestations with some common pregnancy-specific diseases（severe preeclampsia，HELLP syndrome），so they are most likely misdiagnosed or there may be missed diagnosis.This article summarizes the clinical manifestations，pathogenesis，diagnostic criteria，differential diagnosis，and therapy.It provides reference for clinicians' judgment and treatment.

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Monitoring and delivery decision-making for pregnancy complicated with leukemia.  CUI Jian-jian, MEI Heng, ZHAO Yin 2022, 38(12): 1178-1182.  DOI: 10.19538/j.fk2022120108 Abstract ( )   Leukemia is one of the common malignant clonal diseases of hematopoietic stem cells，which can lead to abnormal white blood cells，anemia，thrombocytopenia or significant increase.Leukemia occurring during pregnancy is relatively rare，and the annual incidence reported abroad is about 1/100，000 to 1/10，000.Leukemia occuring during pregnancy increases the risk of hemorrhage，infection，DIC，even death etc.，during pregnancy and perinatal period，it also increases the risk of miscarriage，teratogenesis，stillbirth，fetal growth restriction，and preterm birth.Due to the limited number of cases and the lack of large-scale clinical studies，there is no unified management guideline or clinical consensus for pregnancy complicated with leukemia in China，which brings great challenges to obstetricians.This article intends to summarize the monitoring and delivery decision-making of pregnancy complicated with leukemia on the basis of referring to domestic and foreign literatures，aiming to provide a reference for the clinical management of pregnancy complicated with leukemia.

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Perinatal management of pregnancy complicated with aplastic anemia. HE Li-dan, HU Ji-fen 2022, 38(12): 1182-1184.  DOI: 10.19538/j.fk2022120109 Abstract ( )   Aplastic anemia is a serious and rare complication of pregnancy which may lead to maternal anaemia，infection，bleeding，fetal growth restriction and intrauterine death during pregnancy and childbirth.A series of measures are expected to improve the outcomes of the mothers and newborn babies and minimize the burden of disease and complications， including comprehensive and detailed assessment of the condition before pregnancy，choosing the best time for pregnancy，multidisciplinary management and treatment after pregnancy，medical support or medication when necessary，peripartum decision of childbirth timing and delivery mode according to the condition of the complications，active prevention of postpartum bleeding and infection and follow-up examination and treatment by hematology department after delivery.