Similarly, bleeding complications, particularly PPH,
are associated with significant morbidity and mortality
in pregnancy and postpartum [4, 13]. In a large prospective
multicentre study including 562 women with cardiac
disease, cyanotic cardiac disease and peripartum heparin
use were associated with 27- and 7-fold elevated risks
of PPH, respectively [18]. It was hypothesised that the
association of the former with PPH was a consequence
of reported haemostatic defects in this patient cohort,
however the precise mechanism remains poorly characterised