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Obstetric management of adolescents with bleeding disorders.

Publication ,  Journal Article
James, AH
Published in: J Pediatr Adolesc Gynecol
December 2010

Adolescents with bleeding disorders who become pregnant must contend with the dual challenges of their bleeding disorder and their pregnancy. Adolescents are more likely to terminate a pregnancy than adult women, and when they do carry a pregnancy, they are more likely to deliver prematurely. Otherwise, they are at risk for the same complications that adult women with bleeding disorders experience, particularly bleeding complications postpartum. Since one half to two thirds of adolescent pregnancies are unplanned, issues related to reproduction should be addressed during routine visits with the pediatrician, hematologist or gynecologist. Girls who are at risk of being carriers for hemophilia A and B, severe von Willebrand disease, and other severe bleeding disorders should have their bleeding disorder status determined before they become pregnant. During pregnancy, a plan should be established to ensure that both mother and fetus deliver safely. Young women at risk for severe bleeding or at risk of having a severely affected infant should be referred for prenatal care and delivery to a center where, in addition to specialists in high-risk obstetrics, there is a hemophilia treatment center or a hematologist with expertise in hemostasis. Prior to delivery or any invasive procedures, young women at risk for severe bleeding should receive prophylaxis. Since administration of desmopressin may result in hyponatremia, whenever available, virally inactivated or recombinant clotting factor concentrates should be used for replacement as opposed to fresh frozen plasma or cryoprecipitate.

Duke Scholars

Published In

J Pediatr Adolesc Gynecol

DOI

EISSN

1873-4332

Publication Date

December 2010

Volume

23

Issue

6 Suppl

Start / End Page

S31 / S37

Location

United States

Related Subject Headings

  • von Willebrand Diseases
  • Prevalence
  • Pregnancy in Adolescence
  • Pregnancy Complications, Hematologic
  • Pregnancy
  • Postpartum Hemorrhage
  • Obstetrics & Reproductive Medicine
  • Humans
  • Hemorrhagic Disorders
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
James, A. H. (2010). Obstetric management of adolescents with bleeding disorders. J Pediatr Adolesc Gynecol, 23(6 Suppl), S31–S37. https://doi.org/10.1016/j.jpag.2010.08.004
James, Andra H. “Obstetric management of adolescents with bleeding disorders.J Pediatr Adolesc Gynecol 23, no. 6 Suppl (December 2010): S31–37. https://doi.org/10.1016/j.jpag.2010.08.004.
James AH. Obstetric management of adolescents with bleeding disorders. J Pediatr Adolesc Gynecol. 2010 Dec;23(6 Suppl):S31–7.
James, Andra H. “Obstetric management of adolescents with bleeding disorders.J Pediatr Adolesc Gynecol, vol. 23, no. 6 Suppl, Dec. 2010, pp. S31–37. Pubmed, doi:10.1016/j.jpag.2010.08.004.
James AH. Obstetric management of adolescents with bleeding disorders. J Pediatr Adolesc Gynecol. 2010 Dec;23(6 Suppl):S31–S37.
Journal cover image

Published In

J Pediatr Adolesc Gynecol

DOI

EISSN

1873-4332

Publication Date

December 2010

Volume

23

Issue

6 Suppl

Start / End Page

S31 / S37

Location

United States

Related Subject Headings

  • von Willebrand Diseases
  • Prevalence
  • Pregnancy in Adolescence
  • Pregnancy Complications, Hematologic
  • Pregnancy
  • Postpartum Hemorrhage
  • Obstetrics & Reproductive Medicine
  • Humans
  • Hemorrhagic Disorders
  • Female