During pregnancyCareful management of your blood cell levels reduces pregnancy risks. Women who have been diagnosed with myeloproliferative neoplasms (MPNs) need careful management during pregnancy to ensure that both mother and baby remain safe and healthy. Early in pregnancy During the first trimester of pregnancy, the mother’s blood volume increases as her body gets ready to nourish the fetus. The increase in blood volume may mean that you will need fewer phlebotomies or a lower dose of interferon during pregnancy. The first trimester is also the time when women can miscarry, but careful management of your blood cell levels will reduce the risks. Late in pregnancy In the second and third trimesters of pregnancy, the placenta provides more and more blood supply to the baby as it continues to grow. Women who have MPNs have slightly thicker and stickier blood than normal. This can mean that the heart needs to pump hard to push the blood through the placenta. This in turn can cause the blood pressure to rise. High blood pressure in pregnancy is called “pre-eclampsia”. Your health care team will monitor your blood pressure all through your pregnancy to ensure that you and your unborn child are safe. If your blood pressure begins to rise, you may need to be monitored in hospital and you may possibly be induced so that you can deliver your baby a little early. This can often be the safest solution for both mother’s and baby’s health if you develop pre-eclampsia. It is important to monitor the growth of your baby in pregnancy this is done using ultrasound scans, these scans and other visits to clinics and midwife appointments are important for yours and your baby’s health.