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Semin Thromb Hemost 2023; 49(04): 371-381
DOI: 10.1055/s-0042-1758117
Review Article

Planning Pregnancy and Birth in Women with Inherited Bleeding Disorders

A. Kinga Malinowski
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
2   Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Canada
,
Rezan Abdul-Kadir
3   Department of Obstetrics and Gynaecology and Katharine Dormandy Haemophilia and Thrombosis Centre, The Royal Free NHS Foundation Hospital, London, United Kingdom
4   Institute for Women's Health, University College London, London, United Kingdom
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Abstract

Inherited bleeding disorders are characterized by a diverse clinical phenotype within and across specific diagnoses. von Willebrand disease (VWD), hemophilia A, and hemophilia B comprise 95 to 97% of inherited bleeding disorders, with the remaining 3 to 5% attributed to rare bleeding disorders, including congenital fibrinogen disorders, factor deficiencies (affecting FII, FV, FV + FVIII, FVII, FX, FXI, and FXIII), and platelet function defects. The pregnancy, birth, and the puerperium may be adversely influenced in the setting of an inherited bleeding disorder depending on its type and clinical phenotype. Obstetric hemostatic challenges may sometimes also unmask the presence of a previously unknown inherited bleeding disorder. This review aims to address the approach to pregnancy and birth in the context of an inherited bleeding disorder and highlights the significance of multidisciplinary input into the care of these women.

Keywords

bleeding disorders - pregnancy - delivery - postpartum hemorrhage


Publication History

Article published online:
11 November 2022

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