Abstract Number: PB2557
Meeting: ISTH 2020 Congress
Background: Prenatal diagnosis (PND) is an integral aspect of care provided to carriers of haemophilia as knowledge of gender and haemophilia status of the fetus determines obstetric management.
Aims: Analysis of attitudes towards PND.
Methods: Retrospective cohort analysis.
Data collected through review of medical records of carriers of haemophilia carriers wo attended for obstetric management.
A standardiser questionnaire was sent by post to all eligible carriers.
Results: We present a 10-year (2005-2016) review of PND in carriers of haemophilia offered at the Royal Free Hospital, London.
41 carriers of haemophilia had obstetric care in 73 pregnancies. Uptake of non-invasive diagnosis (NIPT) was 90% and invasive PND was 15%. This was reduced compared to previous two decades (20% and 35% in 1985-1995 and 1995-2005, respectively). Year of pregnancy (p= 0.0010), severity of haemophilia (p= 0.004) and family history of haemophilia complications (p= 0.0012) were factors that significantly influenced uptake of invasive testing. The rate of termination of pregnancy was 1.4% (1/73);lower than 5/90 (5.5%) in the previous decade.
59 deliveries (including 13 female and 45 live male births) wee managed; mode of delivery was a planned CS in 66% and haemophilia was the primary indication in 59% cases. The CS rate was 38% in male babies compared to 14% female counterparts.
27% of carriers who responded to the questionnaire would not opt for invasive testing in pregnancy due to fear of fetal loss. All 41 respondents stated that they would opt for NIPT to confirm the haemophilia status of the fetus should this become available, and that they would find this approach less stressful.
Conclusions: The options for haemophilia are expanding with a drive towards achieving non-invasive approaches. A non-invasive test to confirm the haemophilia status of the fetus is of exceptional importance and required urgently.
To cite this abstract in AMA style:Turan O, Davies J, Pollard D, Musarara M, Abdul-Kadir R. The Attitudes of Haemophilia Carriers towards Prenatal Diagnosis and Mode of Delivery [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-attitudes-of-haemophilia-carriers-towards-prenatal-diagnosis-and-mode-of-delivery/. Accessed December 8, 2021.
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