Women with spina bifida in pregnancy require complex multi-disciplinary management. Most women have uncomplicated pregnancies; however, complications are more frequent than in ‘low risk’ pregnancies. Careful antenatal planning and management of the complications can optimise outcome. There are currently no guidelines on the management of pregnant women with spina bifida, but there is a growing body of evidence from case reports and series examining the antenatal and postnatal course of these women. In this review, we examine the available literature and provide a framework on the prenatal counselling, antenatal, intrapartum and postnatal management of pregnant women with spina bifida.
Pyruvate kinase deficiency (PKD) is a rare non-spherocytic type of haemolytic anaemia. During pregnancy, women with severe PKD are at increased risk of infection, thrombosis, hypertension, fetal growth restriction and anaemia. Management of such cases requires close collaboration between a haematologist and an obstetrician. We report a case of severe PKD in pregnancy with good maternal and fetal outcome.
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