ABSTRACT
Iron deficiency is by far the commonest cause of anaemia and iron deficiency anaemia is the commonest haematological problem in pregnancy. Pernicious anaemia is associated with other autoimmune conditions (Addison's disease, vitiligo) and is caused by intrinsic factor antibodies, leading to vitamin B12 malabsorption. Essential thrombocythaemia, causing an isolated thrombocytosis, is a myeloproliferative disorder and is rare in women of childbearing age. Women with essential thrombocytosis have an increased risk of adverse pregnancy outcome, including FGR, possibly related to placental thrombosis. Danazol, vincristine, rituximab, dapsone and thrombopoietin receptor agonists (e.g. eltrombopag) have been successfully used for severe resistant cases in pregnancy. The obstetric patient with massive bleeding should be managed according to pre-defined and agreed protocols in close collaboration with haematology and anaesthetic staff. Various complement abnormalities (including specific deficiencies and antibodies) are screened for at the National Renal Complement Therapeutics Centre in Newcastle, UK.
