Polycythemia vera and pregnancy: experience of four pregnancies in a single patient

The association of polycythemia vera (PV) and pregnancy is rare. The estimated incidence ranges from 0.04 per 100,000 in women aged 20-34 years to 0.25 per 100,000 in those aged 35-39 years. The management of pregnant patient with PV may be problematic; less than 50 pregnancies have been reported so far in PV.

We hereby describe four pregnancies in a woman where PV was diagnosed in the fourth pregnancy. Aspirin and phlebotomy were used to maintain cell count in normal range and to avoid thrombotic complications.

Pregnancy in PV appears to be associated with significantly better outcome with tailor-made management for achieving good hematocrit control, low-dose aspirin and good maternal and fetal surveillance.