Acquired factor VIII inhibitors in pregnancy: data from the Italian Haemophilia Register relevant to clinical practice.
BJOG
; 110(3): 311-4, 2003 Mar.
Article
em En
| MEDLINE
| ID: mdl-12628274
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.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Hematológicas na Gravidez
/
Fator VIII
/
Gravidez
/
Terapia de Imunossupressão
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Inibidores dos Fatores de Coagulação Sanguínea
/
Hemofilia A
Tipo de estudo:
Diagnostic_studies
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
Idioma:
En
Ano de publicação:
2003
Tipo de documento:
Article