Abstract Number: PB0713
Meeting: ISTH 2021 Congress
Background: Women with inherited bleeding disorders (IBD) are at risk of bleeding complications associated with pregnancy.
Aims: To evaluate the incidence of bleeding complications and obstetric outcomes in women with IBD.
Methods: Retrospective medical records review of the pregnant women with IBD from 2005-2020 in our hospital. Demographic, clinical and therapeutic features were registered.
Results: 39 pregnancies among 25 patients were included. Table 1 shows factor deficiency type and number of pregnancies. Median age at pregnancy: 38 years (range: 33-47), median age at diagnosis: 30 years (range: 2-41). Diagnosis of IBD during or after pregnancy in 3 patients (12%). Six patients (24%) reported history of bleeding (all showed heavy menstrual bleeding), only one patient (2A VWD) showed a positive ISTH-BAT score. 9 (23.1%) previous miscarriages were observed in 7 patients. Delivery plan was available in 38 pregnancies. Regarding delivery: 31 vaginal (2 instrumented), 7 cesarean section and 1 therapeutic abortion (fetal malformation). Regional block was performed in 31 pregnancies without reported complications. Regarding factor level 9 patients reached normal levels in 12 pregnancies. Hemostatic treatment was administered before delivery and/or regional block in 12 pregnancies (Table 2). Postpartum antifibrinolytic treatment lasts 3-5 days in 6 patients and 4 weeks in the GT patient. No thromboembolic complications were observed. Three patients (7.7%) developed PPH: 2 primary (FVII deficiency and SHB carrier) and 1 secondary (2A VWD). No significantly differences between age and risk of PPH were observed and TXA didn´t significantly reduce the risk of secondary PPH (p=0.303). No bleeding complications were observed among newborns.
Conclusions: Risk of PPH is increased in women with IBD. A multidisciplinary team approach with individualized delivery plan including recommended mode of delivery, methods of pain relief, prophylactic hemostatic treatment when it is required and need of antifibrinolytic therapy to prevent maternal and newborn bleeding complications, can minimize these risks.
To cite this abstract in AMA style:Fernández Mosteirín N, Calvo Villas JM. Impact of Inherited Bleeding Disorders on Pregnancy and Postpartum Hemorrhage [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/impact-of-inherited-bleeding-disorders-on-pregnancy-and-postpartum-hemorrhage/. Accessed September 16, 2021.
« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/impact-of-inherited-bleeding-disorders-on-pregnancy-and-postpartum-hemorrhage/