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Access through your institution Buy or subscribe Hydroxyurea (HU) is an antineoplastic drug currently used in the management of many myeloproliferative disorders and especially in essential

thombocythemia (ET). The management of pregnancy in women with a myeloproliferative disorder is a real dilemna. Being faced directly with the problem of information and counselling about HU

exposure in pregnancy, we decided to collect and evaluate data on the outcome of pregnancy following exposure to hydroxyurea because of essential thrombocythemia (ET), chronic myeloid

leukaemia (CML), chromic myeloid splenomegaly (CMSM) and sickle cell disease (SCD). We collected and evaluated pregnancy outcomes of 31 women with HU exposure. Data were collected in two

distinct situations, both with prospective ascertainment of exposure. First, haematologists referred patients for advice to those of us who are geneticists (CTR and ANC). We were faced

directly with the problem of information and counselling about HU exposure in pregnancy. We followed these patients and their children after birth. Second, data were collected from two

teratogen information services in Paris and Lyon. Telephone calls were made by clinicians seeking information about HU-related risk, then follow-up forms were sent and returned after the

pregnancies ended. Overall we collected 31 cases (Table 1). Indications of HU use were ET in 22/31 cases, CML in 6/31 cases, chronic myeloid splenomegaly (CMSM) in 2/31 cases, and SCD in

1/31 cases. HU exposure occurred during the first trimester of pregnancy (weeks 1–14 after last menstruation period) in 22/31 cases, during the first and second trimester in 2/31 cases,

throughout pregnancy in 3/31 cases, and in the third trimester in 2/31 cases. Precise HU exposure duration was unknown in 2/31 cases. Doses varied from 0.5 g/day to 6 g/day orally. Other

drugs were associated, mostly antibiotics and aspirin. Two cases received interferon-alpha but were lost to follow-up. One woman received misulban and melphalan; she gave birth to a healthy

liveborn male infant. The 31 pregnancies with HU exposure ended in 24 liveborn infants (one pregnancy was twice), five induced abortions, one spontaneous abortion and two _in utero_ fetal

deaths (IUFD). Intrauterine growth retardation (IUGR) was found in 2/31 cases by ultrasound. Among the 24 liveborn infants, nine were premature and three had minor abnormalities, namely hip

dysplasia, unilateral renal dilatation and pilonidal sinus. Five presented neonatal respiratory distress after gravidis toxaemia or pre-eclampsia, likely to be as a result of prematurity and

not pulmonary malformation. No baby had major malformations. Fetal examination did not find any malformation in the two IUFD either. Prenatal or post-natal chromosomal analysis was normal

in 6/7 studied cases and 1/7 cases showed inherited inversion of chromosome 9. Alpha fetoprotein was normal in the three amniotic fluids tested. This is a preview of subscription content,

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during pregnancy _Acta Obstet Gynecol Scand_ 2000 79: 803–804 CAS  PubMed  Google Scholar  Download references ACKNOWLEDGEMENTS We would like to thank Dr T Vialle, Dr Orfeuvre and Dr P

Carlier for their collaboration. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Centre de Génétique, Dijon, France C Thauvin-Robinet & A Nivelon-Chevallier * Service de Pédiatrie 1,

Hôpital d'Enfants, Dijon, France C Maingueneau * Institut Européen des Génomutations, Lyon, France E Robert * Centre de Renseignements sur les Agents Tératogènes, CHU Saint Antoine,

Paris, France E Elefant * Hématologie Clinique, Hôpital Le Bocage, Dijon, France H Guy, D Caillot & RO Casasnovas * Clinique Gynécologique et Obstétrique, Hôpital Le Bocage, Dijon,

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Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Thauvin-Robinet, C., Maingueneau, C., Robert, E. _et al._ Exposure to hydroxyurea during pregnancy: a case series. _Leukemia_

15, 1309–1311 (2001). https://doi.org/10.1038/sj.leu.2402168 Download citation * Received: 17 November 2000 * Accepted: 23 March 2001 * Published: 26 July 2001 * Issue Date: 01 August 2001 *

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