Haematology 11: Obstetric Haematology Flashcards
Why are pregnant women anaemic despite an average Red cell mass increase of 120-130% ?
Plasma volume increases by 150% causing a net dilution
What is the WHO recommended daily Iron and folate supplementation for pregnant women ?
60mg iron
400mcg folate
What are pregnant women with thrombocytopenia at risk of when receiving epidural anaesthesia?
Spinal haematoma
What happens to platelets in pregnancy ?
They become larger
They are sometimes counted as RBCs by the FBC machine
List 4 causes of thrombocytopenia in pregnancy ?
Gestational thrombocytopenia (physiological)
Placenta praevia
ITP
MAHA
List 4 causes of MAHA ?
TTP- thrombotic Thrombocytopaenia purpura
HUS- Haemolytic uraemic syndrome
HELLP - haemolysis elevated liver enzymes and low platelets
Pre eclampsia
Why does pregnancy induce a net procoagulant state ?
To rapidly control bleeding at the placental site after delivery
Which anticoagulant factor falls to half the normal level during pregnancy ?
Protein S
Which coagulation factors increase the most during pregnancy ?
Factor VIII and vWF (3-5 fold)
Other factors that increase: Fibrinogen (2 fold) and factor VII (0.5 fold)
Which antifibrolytic factors increase during pregnancy ?
PAI-1 and 2
Which antifibrinolytic factor is produced by the placenta during pregnancy ?
PAI-2
During pregnancy the body assumes a ……….coagulant and ………… fibrinolytic state
Hypercoagulant
Hypofibrinolytic
Is D-dimer useful for exclusion of DVT in pregnancy ?
No
D-dimer is physiologically elevated in pregnancy
Which autoantibody is present in APLS ?
Anti-cardiolipin antibodies
Which 2 medications are recommended in APLS ?
LMWH + aspirin