This guideline is intended for both specialist haematologists and obstetricians who have experience in managing pregnant patients with bleeding disorders. In addition, it may be a useful reference text for obstetric anaesthetists and neonatologists.
This is the first edition of a combined United Kingdom Haemophilia Centre Doctors’ Organisation (UKHCDO) and Royal College of Obstetricians and Gynaecologists (RCOG) guideline although a previous guideline was written by the UKHCDO in 2006.
Women who have inherited bleeding disorders may be at significant risk of bleeding following miscarriage, abortion, antenatal procedures and delivery. They require multidisciplinary specialised care tailored to the individual, with cross-specialty communication, including anaesthetists and neonatologists as necessary.
The conditions covered in this guideline are haemophilia A and B, von Willebrand disease (VWD), factor XI deficiency, rare factor deficiencies, fibrinogen disorders, Bernard Soulier Syndrome (BSS), Glanzmann’s thrombasthenia (GT) and other platelet function disorders.
COVID disclaimer: This guideline was developed as part of the regular updates to programme of Green-top Guidelines, as outlined in our document Developing a Green-top Guideline: Guidance for developers, and prior to the emergence of COVID-19.
Declaration of interests (guideline developers):
Dr S Pavord FRCP, FRCPath, Oxford: Dr Pavord has received honoraria for delivering lectures and has received sponsorship from a variety of companies to attend conferences. Dr Pavord has received payment for a small amount of medico-legal work and gains 2% from the royalties of the “Obstetric haematology manual”.
Dr R Rayment DPhil, FRCP, FRCPath, Cardiff: None declared.
Dr B Madan FRCP, FRCPath, London: Dr Madan has received sponsorship from some companies to attend medical conferences and also to conduct medical conferences organised by Guy's and St Thomas' NHS foundation Trust.
Dr A Cumming PhD, FRCPath, Manchester: Dr Cumming has received payment to deliver a Blood Coagulation course at Manchester Metropolitan University.
Dr W Lester FRCP, FRCPath, Birmingham: Dr Lester has received honoraria for delivering lectures and attending advisory boards and has received sponsorship from a variety of companies to attend conferences.
Dr E Chalmers FRCP, FRCPath, Glasgow: None declared.
Dr B Myers MA, FRCP, FRCPath, Leicester & Lincoln: Dr Myers has received honoraria for delivering lectures and attending advisory boards and has received sponsorship from a variety of companies to attend conferences.
Mrs H Maybury MD, MRCOG, Leicester: Mrs Maybury received an honoraria from Nova Nordisk for delivering the lecture “Diabetes in Pregnancy”.
Dr C Tower PhD, MRCOG, Manchester: Dr Tower has received honoraria for delivering lectures, a small amount of private antenatal work since Oct 2013 and also received payment from Leo Pharma (Innohep) to attend the BMFMS conference in April 2013. Dr Tower has received fees for acting as a medico-legal expert for Obstetric clinical negligence cases since Oct 2013. Dr Tower also receives book royalties from “Ten teachers”.
Mrs RA Kadir FRCOG, London: Mrs Kadir receives royalties for the book “Book royalty from inherited bleeding disorders in women”.