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Post-partum hemorrhage in women with rare bleeding disorders

  • Flora Peyvandi
    Correspondence
    Corresponding author. Flora Peyvandi, MD, PhD. Angelo Bianchi Bonomi Haemophilia and Thrombosis Centre, Via Pace, 9, 20122, Milan, Italy. Fax: +39 02 54100125
    Affiliations
    Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Luigi Villa Foundation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy
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  • Marzia Menegatti
    Affiliations
    Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Luigi Villa Foundation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy
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  • Simona Maria Siboni
    Affiliations
    Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Luigi Villa Foundation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy
    Search for articles by this author
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      Abstract

      Post-partum hemorrhage (PPH) accounts for a substantial fraction of maternal deaths in the general population. Among all women, however, those affected with rare bleeding disorders (RBDs) represent a particular group since to usual bleeding symptoms, they are likely to experience bleedings associated to obstetrical and gynaecological problems. Pregnancy and childbirth, two important stages in the life of a woman, pose a special clinical challenge in women with RBDs, since information about these issues are really scarce and limited to few case reports. These data show that all women with RBDs, except for FXI deficiency, have to be considered potentially at risk for developing PPH, therefore they should be monitored carefully during and immediately after pregnancy. The implication is that women with bleeding disorders may require prophylaxis and/or close observation for several weeks and should be followed by a multidisciplinary team including expertises such as laboratory haematologist, obstetrician-gynaecologist, anaesthesiologist, family physician, and laboratory technician.

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