ABSTRACT
Over the last two decades there has been increasing recognition of the impact of haematological conditions on pregnancy, delivery and the puerperium. Physiological haemodilution of pregnancy exacerbates the anaemia of thalassaemia but women with thalassaemia trait usually remain asymptomatic. Any woman who has a haemoglobinopathy or is a known carrier should ideally undergo prenatal counselling in a specialist centre. Thrombotic thrombocytopenic purpura (TTP) is a relatively rare but important cause of thrombocytopenia in pregnancy as it carries a high mortality and morbidity rate which can be avoided if treatment is started early. Particular risks for the mother in the intrapartum period include postpartum haemorrhage (PPH) and perineal haematoma. Heparin-induced thrombocytopenia is very rare in pregnant women on Low-molecular-weight heparin (LMWH) and routine platelet monitoring is not recommended. Around the time of delivery, the platelet count needs to be raised to a threshold to ensure minimal haemorrhagic complications.
