Haemolytic anaemia in pregnancy: what to know

Red blood cells carry oxygen. In haemolytic anaemia, they are removed from the circulation early, which can leave too few cells available for oxygen delivery. Possible clues include unusual tiredness, breathlessness with activity, dizziness, a fast heartbeat, pale skin or yellowing of the eyes. Causes can include an immune reaction, an inherited red-cell condition, infection, medication or another pregnancy-related problem; the cause cannot be identified from tiredness alone.

Tell your maternity team about new fatigue, dark urine, yellowing, palpitations or reduced exercise tolerance. Assessment may include a blood count, examination of the red cells, bilirubin and other tests that show whether breakdown is occurring. Treatment depends on the cause and severity. Do not start iron on the assumption that every anaemia is iron deficiency; iron therapy may be appropriate only when testing supports it. Keep scheduled antenatal reviews so you and the baby can be monitored.

Seek urgent medical help for breathlessness at rest, chest pain, fainting, confusion, a very fast heartbeat, severe weakness, or rapidly worsening yellowing. Contact your maternity team promptly for dark urine, fever or a sudden decline in how you feel. These symptoms can reflect significant anaemia or another condition that needs timely examination.

Ask what tests will distinguish haemolysis from iron deficiency, what may have triggered the red-cell breakdown, and which medicines or supplements are suitable in pregnancy. Ask how often your blood count and the baby’s wellbeing will be reviewed.