Aplastic anaemia can develop, progress, or relapse during pregnancy, presenting a complex clinical situation that demands close collaboration between haematology, obstetrics, and anaesthesia teams to achieve the best outcome for both mother and baby.
This scenario addresses bone marrow failure occurring in the setting of pregnancy. Many standard therapeutic options used outside pregnancy are not appropriate here, making careful, pregnancy-aware clinical decision-making essential to safe management.
Supportive care is the mainstay of management. The strategy centres on transfusion support and agents selected specifically for their compatibility with pregnancy — several therapies used in non-pregnant patients are not recommended in this setting. The full protocol specifies which agents and when.
Maintain platelet count above 20 × 109/L throughout the pregnancy to limit bleeding risk for mother and fetus.
AA can develop, progress or relapse during pregnancy and it needs obstetricians, anaesthetists and haematologists to work together for the best outcome for the mother and baby.
Supportive care is the mainstay of treatment.
Supportive care remains the mainstay of treatment for AA in pregnancy, aiming to maintain the platelet count above 20 × 109/L with platelet transfusions (3A).
The platelet count should preferably be maintained at >20 × 109/L (expert opinion).
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