title: [Management of pregnancy and childbirth in carriers of haemophilia].
abstract: 3 pregnant women, aged 27, 33 and 31 years respectively, were carriers of haemophilia A. The first patient had a caesarean section without prior measurement or substitution of factor VIII. She gave birth to a healthy boy, but developed severe diffuse abdominal bleeding after a few hours. The second patient had a normal level of factor VIII, and lived 100 km away from the nearest haemophilia treatment centre. Ultrasound investigation revealed a female foetus. She gave birth in the local hospital. The third patient was pregnant with a male foetus, but refused further prenatal investigation. Contrary to medical advice she gave birth at home. For carriers of haemophilia, there are several options for prenatal diagnosis and managing labour and delivery. Early referral is advised and the need for adequate counselling is explained. It is important to have an experienced haemophilia treatment centre nearby, where haematologists, gynaecologists, geneticists and paediatricians cooperate in caring for pregnant carriers of haemophilia.
authors.affiliation: Hemofiliebehandelcentrum, Universitair Medisch Centrum Groningen, Postbus 30.001, 9700 RB Groningen. k.meijer@int.umcg.nl
authors.forename: K
authors.initials: K
authors.lastname: Meijer
authors.forename: K
authors.initials: K
authors.lastname: Bouman
authors.forename: K M
authors.initials: KM
authors.lastname: Sollie
authors.forename: R Y J
authors.initials: RY
authors.lastname: Tamminga
authors.forename: J
authors.initials: J
authors.lastname: van der Meer
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods; D019468:Disease Management; D005260:Female; D006297:Health Services Accessibility; D006467:Hemophilia A / Q000150:complications* / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009774:Obstetrics / Q000379:methods* / Q000592:standards; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000517:prevention & control*; D011256:Pregnancy Outcome