Women with Bleeding Disorders
Many people think that only men can have bleeding disorders and families are often surprised at the diagnosis of a bleeding disorder in a girl or woman. In girls, the first indication that they may have a bleeding disorder is the onset of heavy periods. The most common inherited bleeding disorder which affects both men and women is von Willebrand’s Disease.
In very rare cases, a woman can be born with haemophilia. Some women who are carriers of haemophilia A or B can themselves have lower than normal levels of the clotting factor and can in some cases experience many of the symptoms of haemophilia. For this reason, it is very important for known or suspected carriers to know their factor level. Women can also have other factor deficiencies i.e. factor VIII or factor IX.
When a woman or girl is suspected of having a bleeding disorder, it is very important that she be referred to a haematologist who has an expertise in the diagnosis and treatment of bleeding disorders. Due to the fluctuation of levels at different stages of a woman’s menstrual cycle, it is very important to note at what stage of the menstrual cycle the blood tests are taken.
Pregnancy in women with bleeding disorders
When a woman with a bleeding disorder is pregnant, it is vital that there is good communication between the obstetrician, the haemophilia specialist and the paediatrician so that the pregnancy can be managed safely for mother and baby.
In preparation for delivery, a plan should be agreed for both the mother and the baby. This should include precautions during delivery, blood samples for diagnosis and the availability of appropriate factor concentrate in the event of bleeding, with instructions on dosage. The plan should be copied to the mother, the paediatrician, the obstetrician and the haematologist. It is important that prospective mothers bring copies of their delivery plan to the hospital when they go in to have the baby.
If there is a family history of haemophilia, ensure that you are aware of your carrier status before pregnancy occurs. Inform your obstetrician of your bleeding disorder early in your pregnancy.