Hematologic (Blood) Conditions in Pregnancy

Medical Disorders of Pregnancy menu

Overview

Pregnancy hormones can create challenges for patients with blood disorders. If you have hematologic (blood) conditions, it is important to have specialized care during pregnancy.

Our Obstetric Hematology team includes maternal-fetal medicine (MFM) specialists and hematologists who specialize in blood-related conditions during pregnancy. Together, they care for patients with hematologic and other health conditions, including:

Platelet disorders, such as:
◦ Low platelet count (thrombocytopenia) during pregnancy
◦ Immune thrombocytopenia (ITP)
◦ Inherited low platelet count
◦ High platelet count (thrombocytosis)
Bone marrow problems, such as:
◦ Essential thrombocythemia
◦ Myelofibrosis
◦ Polycythemia vera
◦ Aplastic anemia
Bleeding problems, such as:
◦ Von Willebrand disease
◦ Factor VIII and IX carriers
◦ Factor deficiency including factor XI, VII, X or others
◦ Other inherited bleeding disorders
◦ Undiagnosed bleeding problems
Sickle cell disease
Thalassemia
Issues that can cause a breakdown of red blood cells, such as:
◦ Hereditary spherocytosis
◦ Pyruvate kinase deficiency
◦ Autoimmune hemolytic anemia
◦ Paroxysmal nocturnal hemoglobinuria
Blood clotting problems, including:
◦ Clots in the arms and legs (deep venous thrombosis)
◦ Clots in the lungs (pulmonary embolism)
◦ Clots elsewhere
◦ Stroke
A need for blood thinning medication for other issues, such as:
◦ Irregular heart rate
◦ A mechanical heart valve
◦ Antiphospholipid syndrome
Low white blood cell count (neutropenia)
High white blood cell count such as in chronic myelogenous leukemia

If you are not currently pregnant, we strongly encourage you to talk to your family physician or hematologist before planning a pregnancy. It is important to prepare and make any needed to changes to your medication before becoming pregnant.

Our care

Learn more about the specialized care provided at Mount Sinai Hospital for Medical Disorders of Pregnancy.

This content is intended for informational purposes only and is not intended to be used or relied upon for any diagnostic or treatment purposes. It does not replace the need for consultation with a health-care professional. Please speak with your health-care professional for questions about your health.

Your pregnancy care

We offer both obstetric (OB) and hematology appointments at the Medical Disorders of Pregnancy Clinic.

We also offer appointments to patients who are receiving pregnancy care or hematology care outside of Mount Sinai Hospital. If you live very far from Toronto, a virtual visit might be possible.

If your blood condition could be inherited by your baby, you may be directed to our Prenatal Genetic Diagnosis Clinic for testing and counselling. You might also meet with our pediatrics team to decide on a plan for newborn care after birth.

Patients might also visit our High-Risk OB Anesthesia Clinic to plan for pain management during labour and birth.

Treatment

Pregnancy challenges can vary based on your specific condition.

Your care plan will focus on managing your hematologic condition, while closely monitoring the health of both you and your baby.

It is important to us that you actively participate in decision-making about your care. We will help you understand your treatment options so that you can make the best possible decisions for both you and your baby.

Your MFM specialist and hematologist will work with you to develop a care plan that is specific to your needs.

Potential treatments vary by condition, but may include:

Anticoagulants (blood thinners) for patients at risk of blood clots
Steroids or intravenous immunoglobulin (IVIG) for some patients with immune thrombocytopenia (ITP)
Low-dose aspirin for patients at risk of pre-eclampsia, a pregnancy-related condition
Blood transfusions for patients with beta-thalassemia, aplastic anemia or in specific circumstances for sickle cell disease
Increased fetal monitoring
Birth planning that considers your blood condition

Labour and delivery

Our recommendations for your labour and delivery care may include any of the following:

Meeting with our Obstetric Anesthesia team
Planning a delivery date, which may include induction of labour or Caesarean section, when needed
Having a hematologist provide specific instructions for tests or medications around the time of birth
Monitoring your health throughout labour
Monitoring the health of your baby during labour and after birth, if necessary

We also offer follow-up care with our hematologist up to six weeks after birth.