New Delhi:

During pregnancy, women face a unique type of risk, such as haemophilia, making it a difficult journey for both mother and child. Ensuring a safe and healthy delivery requires a hardcore understanding of these risks and a comprehensive, personalized care planner. If women get the right medical guidance and support, then with haemophilia they can experience successful pregnancies and deliveries.

Understanding the Risks

If there is a male fetus then there is a 50% chance of inheriting haemophilia. This is very risky for newborns as they may suffer severe bleeding issues, such as cerebral hemorrhage, especially in the event of a traumatic delivery.

Haemophilia can significantly affect the health of both the mother and the newborn babies, during pregnancy and childbirth. According to Dr. Dershana Rajaram P, Gynecologist (MBBS, DGO) at Apollo Clinic, Sarjapur:
“Carriers may have low levels of clotting factors, which increases the risk of bleeding, particularly postpartum hemorrhage. Factor replacement treatment and close observation can be necessary.”

The Role of Early Testing and Genetic Counseling

Dr. Dershana further highlights the importance of early genetic testing, especially for women who has a family history of haemophilia. Identifying carrier status and detecting possible haemophilia related mutations early can:
Encourage families to make essential reproductive decisions.

Enable prenatal diagnosis and monitoring

Advise on delivery strategies to reduce diplomatic situation

Create personalized treatment and care planners for both mother and baby.

“Early identification of mutations allows for individualized care and timely interventions, which can significantly improve outcomes for both the mother and the child.” says Dr. Dershana.

Monitoring and managing clotting factor levels after delivery is also very important Prompt evaluation as well as replacement of deficient factors can prevent postpartum haemorrhage, which is very dangerous and a potentially life-threatening complication.

Expert Insights from Haematology

“Haemophilia presents unique challenges during pregnancy and childbirth. While clotting factors naturally increase during pregnancy, they can drop significantly after delivery, increasing the risk of postpartum haemorrhage in carriers.”

He emphasised the need for early genetic testing and how to identify specific mutations and the risk of inhibitor formation. This enables:

Dr. Shrinath Kshirsagar, Haematologist, Haemato-oncologist, and Stem Cell Transplant Physician at K J Somaiya Hospital & Research Centre, adds:

Improved disease management
Educated families on risk status
Implemented Preimplantation Genetic Testing (PGT) to prevent transmission
Created tailored treatment programs to lessen risks.

Postpartum Monitoring and Care

Monitoring of clotting factors closely after birth is crucial. Dr. Shrinath says that the use of medicine like oxytocin helps to stimulate uterine contractions, with the need to monitor vital signs and blood coagulation parameters. Innovative techniques such as Point-of-Care Testing (e.g., ROTEM) provide quick assessment of coagulation status, allowing for timely and effective treatment options.

Conclusion

Women with haemophilia during pregnancy requires proactive planning, early testing, and multidisciplinary care. With not only vigilant monitoring, personalised treatment, but also timely interventions, both mother and the baby can emerge healthy and safe. Empowering families with knowledge and access to proper healthcare ensures that haemophilia does not stand in the way of a safe and fulfilling pregnancy journey.

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