Haemophilia And Childbirth: Risks, Management And Genetic Testing During Pregnancy

Pregnancy is a time of joy for most, but for those with haemophilia, it can present unique challenges. Haemophilia, a rare genetic and congenital disorder, disrupts the blood’s ability to coagulate or clot properly, leading to episodes of uncontrolled bleeding. Haemophilia arises from deficiencies in key blood clotting factors. There are three main types:

• Haemophilia A: Resulting from a mutation in the gene for clotting factor VIII.
• Haemophilia B: Caused by a mutation in the gene for clotting factor IX.
• Haemophilia C: Stemming from a mutation in the gene for clotting factor XI.

According to Dr Sravan Kumar Bodepudi, Consultant – Medical Oncology and Bone Marrow Transplant physician, Manipal Hospital Vijayawada, “These mutations lead to deficiencies in clotting factors, affecting the coagulation process and causing prolonged bleeding, even from minor injuries or internal bleeding, which can be life-threatening if not managed effectively.”

Connection Between Pregnancy and Haemophilia

Pregnancy poses significant implications for both the mother and child in cases of haemophilia. Dr Sravan adds, “Mothers with haemophilia face an increased risk of excessive bleeding during and after childbirth, including postpartum haemorrhage, due to the strain of labour and delivery. Separation of the placenta, an organ supplying nutrients and oxygen to the foetus, can further exacerbate bleeding complications.”

Managing Haemophilia During Pregnancy

“Thankfully, risks associated with haemophilia during pregnancy can be managed. A multidisciplinary team comprising haematologists, obstetricians, and specialised nurses can develop a comprehensive plan ensuring the safety and well-being of both mother and child. 

This plan may include administering clotting factor concentrates before and during delivery to increase deficient clotting factor levels, thereby mitigating excessive bleeding. In some cases, a Caesarean delivery may be recommended to reduce delivery complications,” says Dr Sravan while highlighting the common concerns during delivery.

Haemophilia is a genetic disorder, and there is a possibility of the child inheriting the condition. If the father has haemophilia, there is a 50% chance the child will too. To determine the child’s carrier status or the presence of the haemophilia gene, prenatal genetic testing is often recommended.

Can Newborn Babies Get Haemophilia?

Dr Sravan concludes, “If a child is diagnosed with haemophilia, the healthcare team collaborates with the family to develop a comprehensive management plan, including administering clotting factor concentrates. They closely monitor the child to address any bleeding episodes or complications that may arise.”