Pregnancy and Delivery

Pregnancy, delivery and the postpartum period in WGBD require special attention.1 ” Despite improved haemostasis, however, women with bleeding disorders often do not achieve the same levels of clotting factors as other women and, therefore, are at an increased risk of bleeding complications with pregnancy”.2 There is luck of data that most women with bleeding disorder have more bleeding during pregnancy and that they have more miscarriages then general population. Only exception is fibrinogen or FXIII deficiencies.1-4 Different risks associated with child bearing should be discussed with the MBDP.

There is an evidence that women with bleeding disorders have a higher risk of post-partum hemorrhage than the general population.1-4 Also, there is a risk associated with bleeding to the newborn during the delivery.5Bleeding risks for mother and the child and the mode of delivery should also be discussed during prenatal planning with MBDP. 1

Pregnancy should be accomplished by a multidisciplinary team of specialists, including a hematologist, an obstetrician/gynecologist and an anesthesiologist, all of who are familiar in the management of women with bleeding disorders. 5 The best delivery scenario for women with a bleeding disorder is to have access to a pediatric hematologist and be under the supervision of Manitoba Bleeding Disorders Program. The best advice is to talk to your hematologist and discuss if you need to be followed by a high-risk obstetrician. 3