title: Haematological problems in obstetrics.
abstract: 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.
authors.affiliation: Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Canada; Ottawa Blood Disease Centre, The Ottawa Hospital, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. Electronic address: mrodger@ohri.ca.
authors.forename: Marc
authors.initials: M
authors.lastname: Rodger
authors.affiliation: Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Canada; Ottawa Blood Disease Centre, The Ottawa Hospital, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. Electronic address: dsheppard@toh.on.ca.
authors.forename: Dawn
authors.initials: D
authors.lastname: Sheppard
authors.affiliation: Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Canada; Ottawa Blood Disease Centre, The Ottawa Hospital, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. Electronic address: egandara@ohri.ca.
authors.forename: Esteban
authors.initials: E
authors.lastname: Gándara
authors.affiliation: Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Canada; Ottawa Blood Disease Centre, The Ottawa Hospital, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Canadian Blood Services, Ottawa, Canada. Electronic address: atinmouth@ottawahospital.on.ca.
authors.forename: Alan
authors.initials: A
authors.lastname: Tinmouth
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000188:drug therapy; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007938:Leukemia / Q000188:drug therapy; D008223:Lymphoma / Q000175:diagnosis / Q000188:drug therapy; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis* / Q000628:therapy*; D013921:Thrombocytopenia / Q000175:diagnosis / Q000188:drug therapy; D054556:Venous Thromboembolism / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D014842:von Willebrand Diseases / Q000188:drug therapy
keywords: anaemia; haematology; leukaemia; lymphoma; multiple myeloma; venous thromboembolism