For physicians

For physicians - pregnancy complications

In developed countries, thrombotic/ thromboembolic events are a major cause of maternal morbidity and mortality in pregnancy and puerperium. In less developed countries bleeding complications, particularly during delivery, are relevant causes of pregnancy-related death. Both, thrombotic/ thromboembolic events and bleeding, can be caused by an underlying coagulation defect. In addition, (recurrent) miscarriages, preeclampsia and HELLP syndrome can be caused or aggravated by inherited or acquired defects of the hemostatic system. These associations illustrate the high clinical relevance of coagulation defects in the context of pregnancy. Adequate diagnostic work-up of hemostasis can help to prevent or minimize the risk for these pregnancy-related complications.

In our department, women planning a pregnancy or being pregnant present cause of a variety of questions/ problems:

 

Thrombosis/ Thromboembolism

- positive family history for thrombotic/ thromboembolic events

- known or suspected inherited or acquired thrombophilia

- positive history of thrombotic/ thromboembolic events

- acute thrombotic/ thromboembolic events in the pregnancy

 

 Bleeding/ Hemorrhage

 - symptoms of increased bleeding tendency (acute or previously)

 - known or suspected coagulation defects predisposing to bleeding (e.g. von Willebrand disease)

 - anemia and thrombocytopenia in pregnancy

- increased bleeding in pregnancy or during delivery

 

Other pregnancy complications

- (recurrent) miscarriage

- preeclampsia, HELLP syndrome

- disturbed placenta perfusion

- intrauterine fetal growth retardation (IUGR) or intrauterine fetal death (IUFD)

- Morbus haemolyticus fetalis/ neonatorum (MHF/ MHN)

- fetal or neonatal alloimmune thrombocytopenia (FAIT/ NAIT)