ESSENTIAL THROMBOCYTHEMIA IN PREGNANCY: A LITERATURE REVIEW

Abstract

This study aims to review the scientific literature on essential thrombocythemia (ET) and its implications during pregnancy, emphasizing maternal and fetal risks and the safest therapeutic strategies. This is a narrative literature review conducted between 1991 and 2024 in the SciELO, PubMed, and LILACS databases, using the descriptors “essential thrombocythemia,” “pregnancy,” and “treatment,” in Portuguese and English. Articles in Portuguese, English, and Spanish that addressed the relationship between essential thrombocythemia and pregnancy, considering clinical, diagnostic, and therapeutic aspects, were included; those not directly related to the topic were excluded. The results indicate that ET is a chronic myeloproliferative disease characterized by excessive megakaryocyte proliferation and increased circulating platelets, generally associated with the JAK2 V617F mutation.  This mutation contributes to a prothrombotic state, which, combined with the physiological changes of pregnancy, significantly increases the risk of thrombosis, bleeding, spontaneous abortions, premature birth, intrauterine growth restriction, and fetal death. Diagnosis is based on complete blood count, bone marrow biopsy, and molecular testing, while treatment includes low-dose aspirin, low-molecular-weight heparin, and interferon, the latter being the only safe cytoreductive agent during pregnancy. It is concluded that essential thrombocythemia requires multidisciplinary and individualized monitoring during pregnancy, with na emphasis on risk factor control and constant laboratory monitoring. Appropriate management and early diagnosis are essential to minimize maternal and fetal complications and ensure better obstetric outcomes.