Document Detail


The optimal mode of delivery for the haemophilia carrier expecting an affected infant is caesarean delivery.
MedLine Citation:
PMID:  20028425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
While a majority of affected infants of haemophilia carriers who deliver vaginally do not suffer a head bleed, the outcome of labour cannot be predicted. A planned vaginal delivery puts a woman at risk of an abnormal labour and operative vaginal delivery, both of which predispose to intracranial haemorrhage. Furthermore, vaginal delivery does not eliminate the risk to the haemophilia carrier herself. Overall, maternal morbidity and mortality from planned vaginal delivery are not significantly different from those from planned caesarean delivery. Caesarean delivery is recommended or elected now in conditions other than haemophilia carriage, where the potential benefits are not nearly as great. Additionally, vaginal delivery of the haemophilia carrier poses medical/legal risks if the infant is born with cephalohaematoma or intracranial haemorrhage. Caesarean delivery allows for a planned, controlled delivery. Caesarean delivery reduces the risk of intracranial haemorrhage by an estimated 85% and the risk can be nearly eliminated by performing elective caesarean delivery before labour. Therefore, after a discussion of the maternal and foetal risks with planned vaginal delivery versus planned caesarean delivery, haemophilia carriers should be offered the option of an elective caesarean delivery.
Authors:
A H James; K Hoots
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-12-16
Journal Detail:
Title:  Haemophilia : the official journal of the World Federation of Hemophilia     Volume:  16     ISSN:  1365-2516     ISO Abbreviation:  Haemophilia     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-06-11     Completed Date:  2010-09-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442916     Medline TA:  Haemophilia     Country:  England    
Other Details:
Languages:  eng     Pagination:  420-4     Citation Subset:  IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA. andra.james@duke.edu
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MeSH Terms
Descriptor/Qualifier:
Cesarean Section*
Disease Management
Female
Hemophilia A / complications*
Hemophilia B / complications*
Humans
Infant, Newborn
Intracranial Hemorrhages / prevention & control*
Pregnancy
Pregnancy Complications, Hematologic
Risk
United States
Comments/Corrections
Comment In:
Haemophilia. 2010 May;16(3):425-6   [PMID:  20536994 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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