World Hemophilia Day 2021: Things Women With Hemophilia Need To Take Care Of Before Planning Pregnancy
World Hemophilia Day is observed on 17 April each year to spread awareness about this serious condition. 'Adapting to Change' is the theme for the World Hemophilia Day 2021.
World Hemophilia Day 2021: It is an inherited bleeding disorder that prevents blood clotting
- World Hemophilia Day is observed on 17 April each year
- Adapting to Change- is the theme for the World Hemophilia Day 2021
- Expecting mother with hemophilia needs expert monitoring
Hemophilia is an inherited bleeding disorder that prevents the clotting of blood. It can lead to spontaneous bleeding as well as bleeding following injuries or surgery. In simple words, Hemophilia occurs due to inability of the body to produce clotting factors. Clotting factors are specialised proteins which act in a concerted fashion to prevent or stop bleeding. Thus, patients suffering from hemophilia often present with atypical or excessive bleeding and poor clotting. They also tend to bleed longer post an injury and have significant risk of internal bleeding as well. When the bleeding happens in vital organs like the brain or intestines, it can prove to be fatal.
Two main types of hemophilia are Hemophilia A and Hemophilia B. Both types of Hemophilia occur due to a genetic mutation affecting the X chromosome. As men have only one X chromosome as compared to women who have two, incidence of hemophilia is much higher in males. Women are mainly carriers of this disease but experience suggests that even hemophilia carriers have higher risk of bleeding as compared to the general population.
Women with hemophilia and pregnancy
Any woman with a history of prolonged and excessive bleeding during periods or during minor surgical procedures like tooth extraction should be evaluated for a bleeding disorder.
Women diagnosed with hemophilia should seek medical attention while planning for pregnancy or after it is confirmed. Women are at increased risk of poor pregnancy outcomes due to increased risk of bleeding both during and after pregnancy.
Fortunately during pregnancy, the levels of factor VIII increase significantly especially in patients with mild and moderate hemophilia. This increase in factor levels may not occur in women with severe hemophilia. Hence, these women need to be followed closely throughout the pregnancy and continued on factor prophylaxis to prevent bleeding.
Follow up with a Hematologist trained in dealing with this disorder is crucial to provide optimal outcomes during pregnancy. A multi-disciplinary approach involving a hematologist, obstetrician and anaesthetist ensure minimal bleeding complications during delivery period.
Precautions during pregnancy
Most women who are hemophilia carriers have normal pregnancies. However, they should be under constant monitoring to avoid complications that may arise. This especially holds true for women with borderline factor levels who are at times predisposed to excessive bleeding.
Hemophilia is a debilitating but preventable disease. In any family who has a person affected with hemophilia, women should get themselves screened for hemophilia carrier status.
All hemophilia carriers should have screening during pregnancy to identify if the baby is carrying the hemophilia gene. A skilled hematologist and obstetrician will be able to guide you through this process.
If antenatal screening has not been done, such babies should be screened by factor levels from the cord blood after birth. Babies should also undergo genetic testing to identify severity of mutation. In case the child is diagnosed with hemophilia, repeat testing at 6 months confirms the disease and enables planning of management for the condition prior to serious bleeding episodes.
(Dr. Niti Raizada, Director - Medical Oncology and Hemato-Oncology, Fortis Hospitals, Bannerghatta Road, Cunningham Road, LaFemme, Richmond Town)
(Dr. Hamza Dalal, Hematology, Bannerghatta Road, Fortis Hospital)
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