Recommendations for pregnancy in Fanconi anemia

ABSTRACT

Introduction: Fanconi anemia (FA) is a rare congenital disease that belongs to the family of congenital trilinear bone marrow failure. Most FA patients will suffer bone marrow failure and the main treatment relies on supportive measures or more recently on the use of hematopoietic stem cell transplant. The improvements seen in the management of FA has led women to reach childbearing age and have successful pregnancies. However, these pregnancies are associated with increased complications such as preterm delivery, cesarean delivery, eclampsia and others.

Areas covered: This review highlights on the outcome of pregnancies in FA patients reported in the literature along with practical recommendations.

Expert opinion: Multidisciplinary efforts are required to optimize the management of pregnancy in FA patients. Moreover, the development of a set of recommendations to optimize the treatment is highly necessary.

KEYWORDS:

• Pregnancy
• Fanconi anemia
• maternal outcome
• delivery
• bone marrow transplantation
• fetal outcome

Article highlights

• Improvements seen in the management of FA has led women to reach childbearing age and have successful pregnancies.

• Patients of with FA should be informed with evidence-based data detailing maternal and neonatal morbidity and mortality possibly at preconception or during a regular follow-up visit with a maternal-fetal medicine specialist or hematologist.

• Long-term follow up of FA patients following allogeneic HSCT is necessary.

• Genetic counselling should be offered to all couples affected with FA.

• Routine obstetrical care along with multidisciplinary approach among different specialists taking care of the pregnant patient is strongly recommended for all patients before, during and after pregnancy.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.