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Description:
This session will examine three significant hematologic challenges which impact pregnancy: preservation of fertility in the setting of hematologic malignancies, prevention and management of hemolytic disease of the fetus and newborn, and the hematologic management of postpartum hemorrhage.
Dr. Alison Loren will discuss threats to fertility in patients with hematologic malignancies. These patients, including those undergoing hematopoietic cell transplantation, have ever-improving outcomes, making fertility preservation an essential component of a therapeutic plan. She will review the ways in which cancer therapy can cause infertility and provide an overview of how to discuss these risks with patients and how to manage them. Special considerations in fertility in hematologic malignancy patients will also be addressed.
Dr. Meghan Delaney will review the pathophysiology of hemolytic disease of the fetus and newborn (HDFN), focusing on the laboratory diagnosis and use of laboratory testing to gauge fetal risk. She will discuss approaches to in utero intervention as well as management of the neonate. She will also review the prevention of HDFN with Rh immune globulin (RhIg), including troubleshooting discrepant blood typing with respect to RhIg administration and red cell transfusion selection.
Dr. Evelyn Lockhart will review the global epidemiology of postpartum hemorrhage and recent recommendations for obstetric hemorrhage protocols. She will highlight critical elements of consultative hematology in postpartum hemorrhage, including laboratory testing predictive of severe postpartum hemorrhages and the data regarding use of pharmacotherapy such as antifibrinolytics and fibrinogen concentrates.