Pregnancy outcomes in women receiving eculizumab for the management of paroxysmal nocturnal haemoglobinuria

Obstet Med. 2022 Mar;15(1):45-49. doi: 10.1177/1753495X211019899. Epub 2021 Jun 20.

Abstract

Aims: To report pregnancy outcomes and complications in women receiving eculizumab for the management of paroxysmal nocturnal haemoglobinuria.

Methods: A service evaluation of routinely collected medical records across 49 pregnancies in 21 women.

Results: Eculizumab was used in 37 pregnancies, 31 of which (83.8%) ended in live birth. Eight infants (25.8%) were born prematurely. Over half (54%) of women required increases in their dose of eculizumab to control their haemolysis. There were no reported cases of maternal thrombosis. Major ante/postpartum bleeding necessitating urgent intervention was reported in 10.8% of pregnancies. There were two cases of intrauterine death and three miscarriages. There were no maternal or neonatal deaths. Three newborns required prolonged hospital stays.

Conclusions: Eculizumab appears to benefit pregnant women with paroxysmal nocturnal haemoglobinuria and pregnancy outcomes following its use are largely good.

Keywords: Eculizumab; PNH; haematologic; pregnancy complications.