Hemostatic problems before, during and after delivery

Normal pregnancy and childbirth are known to be associated with marked chan ges in the coagulation and fibrinolytic systems. Generally, enhancement of clotting activity persists to prevent the risk of major hemorrhage. Hemosta tic problems, either associated with a specific complication of pregnancy a nd labor or due to a hereditary or acquired bleeding diathesis or thromboph ilias, present a significant cause of maternal and neonatal morbidity and m ortality This article reviews hemostatic disorders in pregnancy and the per ipartal period from the standpoint of the obstetrician.