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American Academy of Pediatrics
Article

Maternal Hematologic Conditions and Fetal/Neonatal Outcomes of Pregnancy

Irina Murakhovskaya and Kafui A. Demasio
NeoReviews February 2021, 22 (2) e95-e103; DOI: https://doi.org/10.1542/neo.22-2-e95
Irina Murakhovskaya
∗Department of Hematology and Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
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Kafui A. Demasio
†Department of Obstetrics and Gynecology, Maternal and Fetal Medicine, St Johns Riverside Hospital, Yonkers, NY
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  • Abbreviations:
    GP:
    glycoprotein
    HPA:
    human platelet antigen
    ICTM:
    International Collaboration for Transfusion Medicine
    IVIG:
    intravenous immunoglobulin
    NAIT:
    neonatal alloimmune thrombocytopenia
    PT:
    prothrombin time
    PTT:
    partial thromboplastin time
  • Abstract

    Hematologic conditions in reproductive-age women can complicate pregnancy and the neonatal period. Affected pregnancies have a higher risk of severe morbidity and mortality. Coagulation factor changes that occur in the normal state of pregnancy can delay detection and recognition of a bleeding disorder in cases without an apparent bleeding history, thus hindering the appropriate management during gestation and the neonatal period. In addition, unique maternal immunologic changes occur during pregnancy, which are meant to protect the fetus who shares paternal antigens. Rarely, derangement of the maternal immune system may result in alloimmunization against fetal platelet antigens, leading to the development of fetal and/or neonatal thrombocytopenia. Bleeding and platelet disorders pose significant risk of intracranial hemorrhage for the fetus and newborn that is associated with significant morbidity and mortality. We discuss contemporary diagnosis and management of rare bleeding and platelet disorders in pregnancy and their effect on the neonatal period.

    • Copyright © 2021 by the American Academy of Pediatrics

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    NeoReviews
    Vol. 22, Issue 2
    1 Feb 2021
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    Maternal Hematologic Conditions and Fetal/Neonatal Outcomes of Pregnancy
    Irina Murakhovskaya, Kafui A. Demasio
    NeoReviews Feb 2021, 22 (2) e95-e103; DOI: 10.1542/neo.22-2-e95

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    Maternal Hematologic Conditions and Fetal/Neonatal Outcomes of Pregnancy
    Irina Murakhovskaya, Kafui A. Demasio
    NeoReviews Feb 2021, 22 (2) e95-e103; DOI: 10.1542/neo.22-2-e95
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    • Article
      • Abstract
      • Practice Gaps
      • Objectives
      • Introduction
      • Hemophilia
      • Neonatal Alloimmune Thrombocytopenia
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