Pregnancy & childbirth

There are several situations that may occur during or immediately after pregnancy and require treatment with blood products including anaemia, bleeding, prevention of haemolytic disease of the newborn and immune platelet disorders.

What causes anaemia in pregnancy?

Having a baby is an exciting time. But it does place some demands on your body. There is an increase in the need for iron and it is common for pregnant women to develop iron deficiency and anaemia. If this is found early enough it can usually be treated with iron supplements. Occasionally intravenous iron is required if you can’t absorb oral iron or have unmanageable side effects. Intravenous iron is also used if you need to increase your iron levels quickly, for example if your baby is due very soon. Rarely, if iron deficiency and anaemia are not treated and become very severe, a red cell transfusion may be required to protect you and your baby. Learn more about iron deficiency.

When can bleeding occur?

Bleeding can occur throughout any stage of pregnancy. In early pregnancy, the main causes are implantation of the pregnancy outside of the womb (ectopic pregnancy), miscarriage, and diseases of the reproductive system. Although bleeding may be heavy, very few women require blood transfusion.

Later in pregnancy the causes of significant bleeding include problems with the placenta and, rarely, rupture of the uterus (womb). Bleeding after childbirth is usually due to the uterus not contracting properly following delivery. Other causes include trauma during delivery, and retained pieces of the placenta in the uterus. If the bleeding is severe, transfusion of red cells, platelets and plasma products may be required.

 

What is haemolytic disease of the newborn?

If a baby is RhD positive and the mother is RhD negative, the mother may develop antibodies (attack molecules) to the baby’s red blood cells. The baby’s red blood cells may be destroyed which leads to anaemia. This is called haemolytic disease of the newborn (HDN). If the baby develops severe anaemia a transfusion of red cells may be needed. HDN can be prevented by giving the mother an injection of a special blood product called Anti-D (RhD immunoglobulin) during pregnancy and after delivery.

What are immune platelet disorders?

Sometimes platelet antibodies are produced by the mother and cross over the placenta and destroy the baby’s platelets, which increases the risk of bleeding and complications. The mother is treated for this condition with intravenous immunoglobulin and the baby may require transfusions with specially typed platelets until delivery and in the first few days of life.