Hematologic (Blood) Conditions in Pregnancy
Learn more about pregnancy care for patients with a wide range of blood-related conditions.
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.
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.