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Special Considerations

Surgery. Patients with PV have increased risk for bleeding complications after surgery. Because your surgeon may not be aware of your increased risk for bleeding and blood clots, coordination between your surgeon and your hematologist-oncologist is very important. For elective surgeries, it is recommended that your platelet and red blood counts be in normal range before the surgery occurs. Aspirin use should be discontinued one week prior to an elective surgical procedure and then restarted 24 hours after the surgery, or when considered acceptable depending on the level of bleeding risk. Anticoagulant therapy should likewise be suspended prior to surgery and restarted after surgery, again when considered acceptable depending on bleeding risk. There should also be a plan to minimize the risk for deep vein thrombosis after surgery.

Pregnancy. Although MPNs typically develop later in adulthood, some people younger than age 40 are diagnosed with PV. Pregnancies are considered high-risk in younger women with PV. If you have PV and are considering a pregnancy, it is recommended that you meet with an obstetrician specializing in high-risk pregnancies before you become pregnant. Your doctor may recommend taking aspirin during and shortly after your pregnancy. Sometimes, use of an injectable anticoagulant called “enoxaparin (Lovenox®)” is recommended for 6 weeks following the delivery of the child. Hydroxyurea should not be taken during pregnancy or while breastfeeding, as it may harm your baby. If you are taking hydroxyurea, you may switch to interferon during your pregnancy.

To download lists of suggested questions to ask your healthcare providers, click here.


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