Obstetric Haematology

Pregnancies in women with haematological (blood) disorders need to be carefully managed to reduce complications to mother and baby. Pregnant women are subject to physiological changes that may place them at risk of certain haematological disorders such as blood clots or low blood counts in the course of their pregnancy. At the Obstetric Haematology clinic, women are jointly reviewed by a dedicated team of haematologists and obstetricians who specialize in the management of pregnancy with haematological disorders.

Conditions

The conditions seen at the clinic include but are not limited to:

Pregnancy planning for patients with known haematological disorders
Anaemia due to iron deficiency, vitamin B12 deficiency or other causes
Low platelet counts due to autoimmune thrombocytopenic, nutritional causes or gestational thrombocytopenia
Blood clotting disorders including genetic predispositions and acquired disorders such as antiphospholipid syndrome
Bleeding disorders such haemophilia and von Willebrand’s disease
Red cell disorders such as thalassaemia or sickle cell anaemia
Red cell antibodies in pregnancy
Myeloproliferative disorders such as essential thrombocytosis and polycythaemia vera

Referrals

Patients who benefit from Obstetric Haematology consults are usually identified by their respective Obstetricians or Haematologists. We welcome referrals from other specialties and institutions as well.

Pre-conception Planning

For women with known haematological disorders, a consultation with the Obstetric Haematology clinic prior to pregnancy can help them and their partners better understand how the pregnancy may impact the prospective mother’s disease or affect the pregnancy. For heritable diseases such as thalassemia, partner testing may also be recommended to better predict the risk of the baby inheriting the condition. Medications will also be reviewed to ensure that they are necessary during pregnancy and safe for the baby.

Prenatal Care

During the joint clinic, the Obstetric Haematology team will devise a tailored management plan to address maternal issues. Depending on the haematological condition, treatment may include medications such as blood thinners likeantiplatelets or anticoagulants, iron supplements or immunosuppressive therapy. Some mothers with conditions such as thalassaemia may also require transfusions with close monitoring of haemoglobin levels during the course of their pregnancy. Additionally, the baby may require closer monitoring of their foetal growth with dedicated scans. The team will also proactively advise the best nutritional plan for the mother.

Delivery

A birth plan will be formulated by the team of haematologists and obstetricians taking care of the patient together. If necessary, additional discussions and advance planning with the midwives or anaesthetists will be made before the delivery to ensure the best possible outcome.

Postpartum Care

Mothers will be counselled on postpartum care and the need for continued treatment as well as the safety of breastfeeding. Should mothers require treatment beyond the postpartum period, they will be seen in our general / specialist haematology clinics or by their respective haematologist again.