Abstract
Objective: To review the clinical problems related to the inhibitor of factor VIII (FVIII) in pregnancy. Design: Retrospective analysis. Setting: Haemophilia and haemotology centres. Population: Patients registered and followed up at the centres. Methods: Data were collected from the Italian Haemophilia Register of acquired FVIII inhibitor. Results: Twenty of 96 cases with FVIII inhibitor were identified postpartum. The time of appearance was 3-150 days postpartum. All but one of the cases were idiopathic; 11/20 patients required blood transfusions. In six patients, the inhibitor was identified because of surgical bleeding, four after hysterectomies carried out because of postpartum haemorrhage. A prolonged activated partial thromboplastin time was present in all women in whom the test was carried out. Nine women did not require treatment because the bleeding was mild; in 11 patients bleeding was promptly controlled by different therapeutic modalities. Immunosuppressive therapy was used to suppress the inhibitor. The majority of the patients who achieved complete remission received steroids; in 6/6 patients who relapsed, a second remission was obtained with combined therapy. Conclusions: In a review of 20 pregnancies with FVIII inhibitor, over a 15 year period, bleeding was controlled in all cases with no fatalities. Correct evaluation of coagulation screening tests, in particular, activated partial thromboplastin time, is essential.
| Original language | English |
|---|---|
| Pages (from-to) | 311-314 |
| Number of pages | 4 |
| Journal | BJOG: An International Journal of Obstetrics and Gynaecology |
| Volume | 110 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2003 |
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ASJC Scopus subject areas
- Obstetrics and Gynaecology
Cite this
Acquired factor VIII inhibitors in pregnancy : Data from the Italian Haemophilia Register relevant to clinical practice. / Baudo, Francesco; De Cataldo, Francesco; Bari, Schiavon M.; Catanzaro, Santaro R.; Firenze, Linari S.; Niguarda, Milano; Mostarda, G.; Policlinico, Milano; Santagostino, E.; Pavia, Gamba G.; Pescara, Dragani A.; Roma, Mazzucconi G.; Torino, Schino P.; Vicenza, Castaman G.
In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 110, No. 3, 01.03.2003, p. 311-314.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Acquired factor VIII inhibitors in pregnancy
T2 - Data from the Italian Haemophilia Register relevant to clinical practice
AU - Baudo, Francesco
AU - De Cataldo, Francesco
AU - Bari, Schiavon M.
AU - Catanzaro, Santaro R.
AU - Firenze, Linari S.
AU - Niguarda, Milano
AU - Mostarda, G.
AU - Policlinico, Milano
AU - Santagostino, E.
AU - Pavia, Gamba G.
AU - Pescara, Dragani A.
AU - Roma, Mazzucconi G.
AU - Torino, Schino P.
AU - Vicenza, Castaman G.
PY - 2003/3/1
Y1 - 2003/3/1
N2 - Objective: To review the clinical problems related to the inhibitor of factor VIII (FVIII) in pregnancy. Design: Retrospective analysis. Setting: Haemophilia and haemotology centres. Population: Patients registered and followed up at the centres. Methods: Data were collected from the Italian Haemophilia Register of acquired FVIII inhibitor. Results: Twenty of 96 cases with FVIII inhibitor were identified postpartum. The time of appearance was 3-150 days postpartum. All but one of the cases were idiopathic; 11/20 patients required blood transfusions. In six patients, the inhibitor was identified because of surgical bleeding, four after hysterectomies carried out because of postpartum haemorrhage. A prolonged activated partial thromboplastin time was present in all women in whom the test was carried out. Nine women did not require treatment because the bleeding was mild; in 11 patients bleeding was promptly controlled by different therapeutic modalities. Immunosuppressive therapy was used to suppress the inhibitor. The majority of the patients who achieved complete remission received steroids; in 6/6 patients who relapsed, a second remission was obtained with combined therapy. Conclusions: In a review of 20 pregnancies with FVIII inhibitor, over a 15 year period, bleeding was controlled in all cases with no fatalities. Correct evaluation of coagulation screening tests, in particular, activated partial thromboplastin time, is essential.
AB - Objective: To review the clinical problems related to the inhibitor of factor VIII (FVIII) in pregnancy. Design: Retrospective analysis. Setting: Haemophilia and haemotology centres. Population: Patients registered and followed up at the centres. Methods: Data were collected from the Italian Haemophilia Register of acquired FVIII inhibitor. Results: Twenty of 96 cases with FVIII inhibitor were identified postpartum. The time of appearance was 3-150 days postpartum. All but one of the cases were idiopathic; 11/20 patients required blood transfusions. In six patients, the inhibitor was identified because of surgical bleeding, four after hysterectomies carried out because of postpartum haemorrhage. A prolonged activated partial thromboplastin time was present in all women in whom the test was carried out. Nine women did not require treatment because the bleeding was mild; in 11 patients bleeding was promptly controlled by different therapeutic modalities. Immunosuppressive therapy was used to suppress the inhibitor. The majority of the patients who achieved complete remission received steroids; in 6/6 patients who relapsed, a second remission was obtained with combined therapy. Conclusions: In a review of 20 pregnancies with FVIII inhibitor, over a 15 year period, bleeding was controlled in all cases with no fatalities. Correct evaluation of coagulation screening tests, in particular, activated partial thromboplastin time, is essential.
UR - http://www.scopus.com/inward/record.url?scp=0037333872&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037333872&partnerID=8YFLogxK
U2 - 10.1016/S1470-0328(03)01935-9
DO - 10.1016/S1470-0328(03)01935-9
M3 - Article
C2 - 12628274
AN - SCOPUS:0037333872
VL - 110
SP - 311
EP - 314
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
SN - 1470-0328
IS - 3
ER -