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Understand the rapidly growing complexities of obstetric hematology and high-risk pregnancy management, with experts in the field. Now in its second edition, this comprehensive and essential guide focuses on providing the best support for patients and clinical staff, to prevent serious complications in pregnancy and the post-partum period for both mother and baby. Wide-ranging and detailed, the guide offers discussions on basic principles of best care, through to tackling lesser-known hematological conditions, such as cytopenias and hemoglobinopathies. Updated with color illustrations, cutting-edge research, accurate blood film reproductions, and practical case studies, the revised edition places invaluable advice into everyday context. This unique resource is essential reading for trainees and practitioners in obstetrics, anesthesia, and hematology, as well as midwives, nurses, and laboratory staff. Clarifying difficult procedures for disease prevention, the guide ensures safety when the stakes are high. Reflecting current evidence-based guidelines, the updated volume is key to improving pregnancy outcomes worldwide.
This chapter concentrates on inherited red cell disorders: sickle cell disease and thalassemia. Care of the patient with thalassemia involves collaboration of hematologists, endocrinologists, diabetologists, cardiologists, with occasional input from other specialities such as hepatology. The sickling disorders are a group of inherited chronic hemolytic anemias with clinical manifestations occurring as a result of the polymerization of hemoglobin S. The clinical manifestations in sickle cell disease are as a result of many interacting pathological processes including: polymerization of HbS, hemolysis and nitric oxide depletion, and vaso-occlusion. All patients with sickling disorders should be jointly managed by an obstetrician and a hematologist with interest and experience in these diseases. Since these pregnancies are high risk, patients will require frequent review by the multidisciplinary team. Deficiencies in red cell enzymes often lead to shortened red cell lifespan.