Normal pregnancy is associated with physiologic changes that affect the hematologic system. The need to focus on the wellbeing of both the mother and baby makes the management of hematologic problems during this time more complex. This session will focus on common reasons for hematologic consultation during pregnancy, including thrombocytopenia, anemia secondary to iron deficiency, and venous thromboembolism (VTE).
Dr. Douglas Cines will provide an update on assessment of the most common causes of thrombocytopenia encountered during pregnancy based on trimester of onset and associated clinical features at presentation. Emphasis will be placed on difficult-to-treat patients with immune thrombocytopenia and new approaches used to diagnose and manage women with thrombotic microangiopathies.
Dr. Christian Breymann will review the primary causes of pregnancy-associated anemia, diagnostic tools for the detection of iron deficiency and anemia during pregnancy, and fetal and maternal consequences of these conditions. Differences between the principles of prevention of iron deficiency and treatment of manifest anemia will be discussed, along with the various types of available iron therapy. There will be a focus on recent data on safe and effective use of intravenous iron preparations.
Dr. Leslie Skeith will summarize available evidence and highlight areas of uncertainty in the prevention of VTE during pregnancy and the postpartum period, as well as anticoagulant management around the time of delivery. She will use the concept of a risk threshold to provide recommendations for the prevention of VTE in pregnant women with thrombophilias and those with prior venous thrombosis.