To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This chapter addresses the practical obstetric and anesthetic management of women on prophylactic heparin and therapeutic anticoagulation in the peri-partum period, and the dilemmas for obstetricians, anesthetists, and hematologists. It considers issues surrounding use of thrombolytic agents in pregnancy, and unusual but complex situations such as cardiopulmonary bypass in pregnancy. Increasing use of prophylactic anticoagulants in pregnancy, both for venous thromboprophylaxis and to modify fetal risk, as in antiphospholipid syndrome, means that more women are now reaching the peri-partum period on anticoagulants, usually a low molecular weight heparin. The safety in pregnancy of other antiplatelet agents such as clopidogrel or ticlopidine at usual therapeutic doses has not been established and they are rarely used. Most of the women requiring prophylactic doses of anticoagulant will be given one of the low molecular weight heparins (LMWH).
This chapter focuses on red cell alloimmunization that is the immune-mediated destruction of erythrocytes initiated by maternal red cell antibodies which reach the fetal circulation by transportation across the placenta, onwards from approximately 12 weeks' gestation. Hemolytic disease of the newborn (HDN) describes the consequences of the antenatal pathogenic process which continues on into the newborn period. Prevention of Rhesus D (RhD) isoimmunization, and improvements in the ante-natal and neonatal care of isoimmunized women and their babies, has all but eradicated serious morbidity and mortality associated with this condition. Exogenous anti-D is produced by exposing RhD negative volunteers to the RhD antigen. The use of intravenous immunoglobulin is well established now in the treatment of neonatal alloimmune thrombocytopenia and HDN. Phenotypic tests of RhD status examine how blood from an individual behaves when it is added to serum containing anti-D antibodies.