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In ET, live birth rate is estimated at 70% with first trimester fetal loss (\u02dc 30%) as the major complication. Risk of pregnancy\u2010associated complications is higher in PV, thus mandating a more aggressive treatment approach. Herein, we appraise the relevant literature, share our own experience and propose management recommendations. Aspirin therapy may offer protection against fetal loss; however the additive benefit of systemic anticoagulation or cytoreductive therapy, in the absence of high risk disease, is unclear. We recommend cytoreductive therapy in the form of interferon alpha in all high risk and select low\u2010risk ET and PV patients with history of recurrent fetal loss, prominent splenomegaly or suboptimal hematocrit control with phlebotomy. In addition, all women with PV should maintain strict hematocrit control &lt;45% with the aid of phlebotomy. Systemic anticoagulation with low molecular weight heparin is advised in patients with history of venous thrombosis. Further clarification awaits prospective clinical trials that implement risk adapted therapeutic interventions.<\/jats:p>","DOI":"10.1002\/ajh.26067","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T19:09:16Z","timestamp":1607627356000},"page":"354-366","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Myeloproliferative neoplasms and pregnancy: Overview and practice recommendations"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9104-6172","authenticated-orcid":false,"given":"Naseema","family":"Gangat","sequence":"first","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4605-3821","authenticated-orcid":false,"given":"Ayalew","family":"Tefferi","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.08.022"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25270"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25303"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26008"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-05-579136"},{"issue":"323","key":"e_1_2_9_7_1","first-page":"1","article-title":"Trends in fertility and mother's age at first birth among rural and metropolitan counties: United States, 2007\u20102017","volume":"2018","author":"Ely DM","year":"2018","journal-title":"NCHS Data Brief"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16453"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2008.03.007"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2018.1506325"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24829"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1802897"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2019-127058"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.20.2611"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-03-460154"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.patbio.2004.02.007"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-07-591610"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-09-046342"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-02-339002"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000211"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-07-444067"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2015.94"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24293"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25713"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12290"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-09-728006"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199609)53:1<6::AID-AJH2>3.0.CO;2-V"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.1999.00614.x"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0609.2000.90214.x"},{"key":"e_1_2_9_30_1","unstructured":"BettiSE RossiE. 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