Hemophilia is a bleeding disorder caused by a problem in one of the X-chromosome genes that tells the body to create clotting factor proteins needed to stop the bleeding. Although women are less likely to inherit or spontaneously develop this problem, it’s important to be aware of it if you are considering a future pregnancy. Use this guide to gain a basic understanding of how it can impact future mothers.

How Hemophilia Can Impact a Pregnancy

What are some possible complications?

Women with low factor levels have an increased risk of bleeding. Although pregnancy raises factor VIII levels, levels still may not be high enough to prevent bleeding complications before, during, and after birth. When the condition isn’t known, the woman is at a higher risk of spontaneous pregnancy loss in the first trimester.

What should I do before getting pregnant?

If you might be a carrier of type A, a lack or decrease of clotting factor VIII, or type B, a lack or decrease of clotting factor IX, you should be evaluated by a coagulation specialist before getting pregnant. As protein factors can change during pregnancy, it’s important to have a reference point. Since hemophilia can develop for the first time in the later stages of pregnancy, it's also beneficial to undergo genetic testing if you are not sure you carry the gene responsible for hemophilia.

What should I do once I’m pregnant?

The pregnancy should be managed by an obstetrician, a hematologist, and an anesthesiologist who all specialize in bleeding disorders. They will need to monitor factor levels and provide factor replacement therapy if your protein levels fall too low. If you have a severe deficiency at the start of the pregnancy, it may be necessary to receive monthly therapy.

A childbirth plan should be put in place early on. Ideally, choose a birth facility that specializes in bleeding disorders and has clotting factor replacement and transfusion services on site.

Can the condition be passed on to the baby?

If you are a carrier of the hemophilia gene, there is a 50% chance a son will inherit the disorder and a 50% chance a daughter will become a carrier. In either case, your delivery doctor shouldn’t use forceps or a vacuum extractor, which might cause head bleeding if the baby inherited the gene.

If you are expecting a boy, circumcision should be avoided if possible. Immediate testing of the umbilical cord should also be performed to determine the baby’s status and if any other necessary treatment, such as a vitamin K shot, is needed to raise a baby's factor IX levels.

If you are thinking about having your first baby, the caring and experienced staff at TTNYD & D OBGYN will help you manage any conditions that could impact the pregnancy. Their compassionate team of physicians is conveniently located in Honolulu, HI, and seeks to provide the highest level of individualized healthcare to patients throughout Oahu. Visit the website to learn more about their range of women’s health services, and call (808) 599-4200 to schedule an appointment.