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Position Statement

A consensus statement on the management of pregnancy and delivery in women who are carriers of or have bleeding disorders

Scott M Dunkley, Susan J Russell, John A Rowell, Chris D Barnes, Ross I Baker, Megan l Sarson, Alison M Street on behalf of the Australian Haemophilia Centre Directors’ Organisation
MJA 2009; 191 (8): 460-463
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.

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©The Medical Journal of Australia 2009 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377