Table 10.

PNH and pregnancy

  • Complications of PNH

    • Anemia (hemolytic, hypoproliferative, or both)

    • Thrombocytopenia

    • Venous thromboembolic events

  • Management recommendations

    • Prior to pregnancy, counsel patient on potential risks and possible need for intervention

    • Management team should include an experienced hematologist and an obstetrician who specializes in high-risk pregnancies

    • Prophylactic anticoagulation with heparin* should begin immediately and continue for 6 weeks after giving birth†

    • Blood products as required for treatment of anemia and thrombocytopenia

 

  • Complications of PNH

    • Anemia (hemolytic, hypoproliferative, or both)

    • Thrombocytopenia

    • Venous thromboembolic events

  • Management recommendations

    • Prior to pregnancy, counsel patient on potential risks and possible need for intervention

    • Management team should include an experienced hematologist and an obstetrician who specializes in high-risk pregnancies

    • Prophylactic anticoagulation with heparin* should begin immediately and continue for 6 weeks after giving birth†

    • Blood products as required for treatment of anemia and thrombocytopenia

 
*

Low-molecular-weight heparin may be advantageous because it is associated with a lower incidence of heparin-induced thrombocytopenia compared with unfractionated heparin. Regardless of the form of heparin used, frequent (at least every other week) monitoring of the platelet count is needed.

†

Warfarin can be used for anticoagulation in the postpartum period.

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