Haematological disorders in pregnancy

During the last four decades, there have been major advances in the understanding and management of the haematological disorders associated with pregnancy. This chapter aims to help update the management and knowledge of some of these conditions. The section on anaemia in pregnancy addresses its prevention, diagnosis, and management. Sickle cell disease is discussed, with its associated complications and the role of preconception and antenatal care in the appropriate set-up. The section on thalassemia highlights the advances in antenatal screening and the management of the different types in pregnancy. A concise updated review on antiphospholipid syndrome in pregnancy is included, addressing its diagnosis and management. Early pregnancy loss is the most common pregnancy complication and its occurrence in association with a thrombophilia is discussed in detail. Women with inherited bleeding disorders and disseminated intravascular coagulopathy may face several haemostatic challenges during pregnancy and childbirth. Pregnancy in these women requires specialized and individualized care. This section covers the management of maternal and fetal complications as well as prenatal diagnosis including new advances for haemophilia carriers. The section on thrombocytopenia outlines the management of low platelets in pregnancy, and the association with severe pre-eclampsia, eclampsia, and HELLP syndrome. There is a section devoted to management of haematological malignancies in pregnancy, which is complex and requires a multidisciplinary approach. An attempt has been made to cover as many subjects in a way that will be of interest and value to both obstetricians and haematologists involved in the care of pregnant women.