Abstract：
Incidents of leukemia in pregnancy are infrequent with only one case found from 75,000 to 100,000 pregnancies. The pathophysiological mechanism of leukemia during pregnancy is still unclear. Leukemia which occurs in pregnancy is usually acute and predominantly the myeloid type.A 35-year-old woman in her fourth pregnancy with a gestational age of 38-39 weeks, came to the emergency department (ED) with complaints of contractions since 4.5 hours before admission. The contraction was not accompanied by discharge, mucus, or blood, and fetal movements was still active. She denied complaints of fever, nausea, vomiting, dizziness, shortness of breath, weakness, fatigue, lethargy, and bleeding. Physical examination results, both palpebral conjunctiva were pale. Laboratory examination results of a complete blood count, white blood cell count were 2,930/uL, hemoglobin 8.3 g/dL, Hct 24.10%, erythrocytes 2.78x106/µL, platelets 62,000/µL. Bone Marrow Aspiration (BMA) revealed Acute Promyelocytic Leukemia (APL).APL is a subtype of Acute Myelogenous Leukemia (AML). Persistent fatigue, recurrent infections, and bleeding are common manifestations of APL. The diagnosis of APL is made by bone marrow aspiration examination, and it is safe for pregnancy. APL therapy in pregnancy uses All-Trans Retinoic Acid (ATRA) and Arsenic Trioxide (ATO). ATRA and ATO are highly teratogenic, but recent studies have reported no fetal abnormalities.Accuracy and speed in diagnosing and initiating APL therapy in pregnancy are essential in preventing serious complications.
摘要：
怀孕期间的白血病事件很少发生，只有一例从75,000至100,000例怀孕。妊娠期白血病的病理生理机制尚不清楚。妊娠中发生的白血病通常是急性的，主要是骨髓型。一名35岁的妇女第四次怀孕，胎龄为38-39周，自入院前4.5小时以来，因宫缩而来到急诊科（ED）。收缩没有伴随着放电，粘液,或者血,胎儿运动仍然活跃。她否认发烧的投诉，恶心,呕吐,头晕,呼吸急促,弱点,疲劳,嗜睡,和出血。体检结果,双眼结膜苍白。全血细胞计数的实验室检查结果，白细胞计数为2,930/uL,血红蛋白8.3g/dL，Hct24.10%，红细胞2.78x106/微升,血小板62,000/微升。骨髓穿刺（BMA）提示急性早幼粒细胞白血病（APL）。APL是急性骨髓性白血病(AML)的亚型。持续性疲劳,反复感染,出血是APL的常见表现。APL的诊断是通过骨髓穿刺检查得出的。怀孕是安全的.妊娠APL治疗使用全反式维甲酸（ATRA）和三氧化二砷（ATO）。ATRA和ATO是高度致畸的,但是最近的研究报告没有胎儿异常。诊断和开始妊娠APL治疗的准确性和速度对于预防严重并发症至关重要。
