Haematological problems in obstetrics

• Normal pregnancy symptoms can mimic serious haematological disease.
• Thrombocytopenia is common in pregnancy and has numerous aetiologies.
• Increased risk of thrombosis in pregnancy necessitates accurate diagnosis.
• Thromboprophylaxis in pregnancy and post partum is indicated for high-risk women.
• Multidisciplinary teams are needed for managing haematologic malignancy in pregnancy.

Physiologic changes occur during pregnancy, which influence normal haematologic values and impact the diagnosis and management of haematologic disease in pregnancy. Physiologic changes of pregnancy also commonly lead to mimicking symptoms of haematologic disease that may prompt investigations for haematologic disease. The toxicity and radiation associated with the diagnostic imaging and pharmacologic management of both benign and malignant haematological conditions during pregnancy present unique challenges. Strategies for diagnosis and treatment must weigh the benefits and risks to the mother while also taking foetal outcome into consideration. In this review, we highlight the common haematologic diseases encountered by obstetricians and try to provide guidance for the most prevalent diagnostic and therapeutic questions. At the other end of the spectrum, we also comment on less common but very challenging haematologic diseases in pregnancy that require multidisciplinary effort to arrive at difficult individual diagnostic and treatment decisions.