Pregnancy & Women’s Haematology in Melbourne
Pregnancy changes the blood and clotting systems in ways that are normal but can complicate interpretation of laboratory results. Iron requirements rise, platelet counts can fall, and the risk of venous thrombosis increases. Women may also enter pregnancy with an existing bleeding disorder, thrombophilia, haemoglobin disorder or history of blood clots. Specialist haematology input can help distinguish normal pregnancy-related changes from conditions that require treatment and can provide a plan for delivery and the post-partum period.
Pregnancy and the weeks after delivery increase the risk of DVT and pulmonary embolism. Women with a previous unprovoked or hormone-associated clot, recurrent thrombosis or certain high-risk thrombophilias may be advised to use preventive anticoagulation during pregnancy or after birth. Low molecular weight heparin is commonly used because it does not cross the placenta. A personalised plan should specify dosing, monitoring where needed and when anticoagulation should be withheld around labour, induction, caesarean section or neuraxial anaesthesia.
Preconception review can be valuable for women with a known bleeding disorder, haemoglobinopathy, previous thrombosis or long-term anticoagulant use. It allows medication to be reviewed before conception and gives the obstetric team time to plan monitoring. Carrier testing for haemoglobin disorders may also have implications for the partner and future pregnancy.
During pregnancy, the haematology plan may evolve as blood counts and clinical risk change. The purpose is to anticipate issues rather than respond only at delivery. For women with bleeding or clotting disorders, a written peripartum plan can help obstetricians and anaesthetists make safe decisions about medication timing, epidural or spinal anaesthesia, delivery and post-partum prophylaxis.
Treatment may include oral or intravenous iron, vitamin replacement, anticoagulant prophylaxis, treatment of immune thrombocytopenia, or factor/haemostatic support for delivery in women with bleeding disorders. The safest option depends on gestation, severity, symptoms and the needs of both mother and baby.
Northern Blood & Cancer Care provides a specialist setting for women who need continuity before, during and after pregnancy. Where hospital-based high-risk care is needed, the team’s appointments within Northern Health and Mercy Hospital for Women support coordination with established obstetric services.
Most pregnancy-related blood changes are managed by a GP, obstetrician or midwife, but specialist input can be helpful when a known blood condition or an abnormal result may affect pregnancy, delivery or the post-partum period. Referral may be appropriate when:
Where a blood disorder is already known, a preconception consultation can be particularly useful because medication and delivery planning can begin before pregnancy progresses.
Northern Blood & Cancer Care brings together Melbourne specialists with complementary clinical, hospital and research appointments. The clinicians most closely associated with this service include:
Northern Blood & Cancer Care brings together a highly experienced team of haematologists, medical oncologists and specialist physicians, with consultations available at Northern Private Hospital in Epping.
Contact our team to arrange an appointment or discuss a referral.
