title: A consensus statement on the management of pregnancy and delivery in women who are carriers of or have bleeding disorders.
abstract: Pregnancy and delivery are critical times for women with bleeding disorders, with mothers, and possibly their affected infants, being exposed to a variety of haemostatic challenges. Management of women with bleeding disorders during pregnancy involves a multidisciplinary team including, but not limited to, an obstetrician, an anaesthetist and a haematologist. This consensus document from the Australian Haemophilia Centre Directors' Organisation (AHCDO) provides practical information for clinicians managing women with bleeding disorders during pregnancy. Included are: the expected physiological response in pregnancy in such women; management of pregnancy, labour and delivery, as well as obstetric anaesthesia issues, postpartum care, and reducing and treating postpartum haemorrhage; and management of infants at risk of a bleeding disorder and of bleeding in neonates. The guidelines were developed after extensive consultation, face-to-face meetings and revisions. The final document represents a consensus opinion of all AHCDO members. Where evidence is lacking, recommendations are based on clinical experience and consensus opinion.
authors.affiliation: Institute of Haematology, Royal Prince Alfred Hospital, Sydney, NSW, Australia. scott.dunkley@sswahs.nsw.gov.au
authors.forename: Scott M
authors.initials: SM
authors.lastname: Dunkley
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Russell
authors.forename: John A
authors.initials: JA
authors.lastname: Rowell
authors.forename: Chris D
authors.initials: CD
authors.lastname: Barnes
authors.forename: Ross I
authors.initials: RI
authors.lastname: Baker
authors.forename: Megan I
authors.initials: MI
authors.lastname: Sarson
authors.forename: Alison M
authors.initials: AM
authors.lastname: Street
mesh_terms: D000773:Anesthesia, Obstetrical / Q000592:standards; D025861:Blood Coagulation Disorders, Inherited / Q000150:complications / Q000628:therapy*; D001779:Blood Coagulation Factors / Q000627:therapeutic use*; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D010348:Patient Care Team; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy*
chemical_list: D001779:Blood Coagulation Factors; D006490:Hemostatics