Essential thrombocythemia (ET) is a chronic myeloproliferative neoplasm characterized by persistently elevated platelet count without a clear secondary cause. Although most patients with ET are between 55 and 60 years of age, it has been estimated that 20% of women with ET are diagnosed during reproductive ages. Miscarriage is the most frequent complication of ET that has been hypothesized to be caused by microcirculatory disturbances and placental microinfarction. Furthermore, pregnant patients with ET are at increased risk of other pregnancy complications such as preterm delivery and intrauterine growth restriction. This study was planned to evaluate pregnancy outcomes and predictors of obstetric complications in pregnant women with essential thrombocythemia (ET). The data of 21 patients with ET were analyzed retrospectively between 2016 and 2020. Age, parity, history of miscarriage, presence of Janus kinase 2 (JAK2) mutation, history of thrombotic events, treatment of thrombocytosis during pregnancy, and obstetrical outcomes including miscarriage were compared. Patients with ET had a significantly higher rate of history of two or more previous miscarriages. Miscarriage and obstetric complications in pregnant women with ET were found to be significantly higher than in the control group. Patients with ET with obstetric complications or miscarriage more frequently had a platelet count of >1000 × 103/μL. Acetylsalicylic acid (ASA) prevented miscarriages, but not obstetric complications, in patients with ET. ET increases miscarriage and obstetric complications in pregnancy. Treatment with ASA may reduce pregnancy losses, but not obstetric complications.
Background/Objectives: Gestational diabetes mellitus (GDM) presents significant risks for both maternal and neonatal health, affecting fetal growth and increasing the likelihood of future diabetes mellitus (DM) development in affected women. The dysregulation of metabolic biomarkers, including catestatin, has been implicated in GDM pathophysiology. However, the clinical significance of catestatin in GDM remains poorly understood, particularly in the context of different therapeutic approaches. Methods: This observational, prospective, and cross-sectional study was conducted to evaluate maternal serum catestatin levels in gestational diabetes mellitus (GDM) patients and healthy controls. Data were collected at a single time point during the second trimester of pregnancy (24 to 28 weeks). Participants were categorized based on their glucose tolerance and GDM management strategies (diet regulation or insulin therapy). Results: Receiver Operating Characteristic (ROC) analysis demonstrated the diagnostic significance of serum catestatin levels in GDM, suggesting a cut-off value of >9.61 ng/mL for discriminating between women with and without GDM. However, further research is needed to elucidate the mechanistic role of catestatin in GDM and its utility in guiding therapeutic interventions. Conclusions: Our study highlights the potential of catestatin as a biomarker for GDM risk stratification and monitoring, complementing existing diagnostic tools. Integrating metabolic biomarkers like catestatin into clinical management approaches may optimize maternal and neonatal health outcomes in GDM. However, the limitations of our study, including its cross-sectional design and sample size, underscore the need for future multicenter studies to validate our findings comprehensively.
1 January 2023 in Revista da Associação Médica Brasileira
In this study, we aimed to determine the impact of the antiangiogenic medications, namely, aflibercept and cabergoline in the prevention and treatment of ovarian hyperstimulation syndrome in a rat model.