Medical milestone: PGI doctors ensure successful pregnancy and delivery in paroxysmal nocturnal hemoglobinuria patient - Hindustan Times
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Medical milestone: PGI doctors ensure successful pregnancy and delivery in paroxysmal nocturnal hemoglobinuria patient

By, Lucknow
Dec 13, 2023 05:24 AM IST

Hemolysis poses a high risk of arterial and venous thrombosis, making pregnancy a relative contraindication for PNH patients.

In an exceptionally rare case, doctors at Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) successfully facilitated pregnancy and delivery in a patient with Paroxysmal Nocturnal Hemoglobinuria (PNH), a rare acquired disorder causing hemolysis—the process of rupturing of the red blood cells.

For representation only (HT File Photo)
For representation only (HT File Photo)

This condition poses a high risk of arterial and venous thrombosis, making pregnancy a relative contraindication for PNH patients. Successful pregnancy outcomes in PNH patients are seldom reported. The patient sought treatment at SGPGIMS in June 2021, presenting symptoms of severe anaemia and jaundice, leading to the diagnosis of PNH.

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Dr Sanjeev (known by a single name) from the department of hematology at SGPGIMS said, “After initial stabilization and control of hemolysis, she expressed her desire to plan a pregnancy. I decided to grant permission after discussing with my head of department, Professor Rajesh Kashyap. Taking the risk could lead to a rare success, and she was kept under strict observation. One factor that helped us was that the patient herself was a medical professional.”

He added, “After successful conception and confirmation of pregnancy, the patient was started on Low Molecular Weight Heparins (LMWH), a class of anticoagulants used therapeutically for the treatment of thrombosis and prophylactically in cases of high thrombosis risk. Following LMWH and aspirin prophylaxis, she was placed on a low dose of steroids to control PNH-induced hemolysis. She progressed well, and on November 10, she delivered a healthy baby girl with a birth weight of 2.8 kg.”

After one month of the successful pregnancy outcome, both mother and child are in good health. The mother continues to receive LMWH prophylaxis and plans to switch to aspirin after eight weeks of delivery.

This marks the first case of a successful pregnancy outcome in a PNH patient in Lucknow and the state. High-risk pregnancies like these can be managed with close supervision from hematologists and obstetricians, according to Dr Sanjeev.

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  • ABOUT THE AUTHOR
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    Anupam Srivastava is a Special Correspondent with Hindustan Times, Lucknow. Has produced exclusive stories in medical, civil aviation, civic, political and other issues for over 20 years.

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