Polycythaemia

There have been few published cases of polycythaemia complicating pregnancy. There may be associated thrombocytopenia or thrombocythaemia. Thrombocytopenia may be dilutional and may not reflect function. Thrombotic events (arterial and venous) do occur and prophylactic aspirin and heparin have been given to prevent them.

In cyanotic heart disease, a haemoglobin concentration greater than 16g/dl is associated with poor fetal outcome; this probably represents both a marker of severity of the underlying disease and impairment of uteroplacental oxygenation resulting from increased blood viscosity.

Coagulation times may be artefactually prolonged in severe polycythaemia.

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