Bleeding Disorders and Pregnancy

Bleeding disorders, also known as coagulopathy, are conditions that affect your body’s ability to clot normally at the site of an injury, resulting in bleeding that can range from mild to severe. The bleeding can be inside or outside the body.

During pregnancy, bleeding disorders can pose serious risks to the mother and baby.

Most bleeding disorders are inherited. Others are acquired, meaning they may develop at any time, in some cases as a result of pregnancy.

Complications of Bleeding Disorders in Pregnancy

Women with bleeding disorders or a history of bleeding are at greater risk of pregnancy complications that include:

• Bleeding during pregnancy
• Severe postpartum hemorrhage that may require transfusion or hysterectomy
• Anesthesia risks during delivery
• Delivery risks to babies with inherited bleeding disorders

Causes of Bleeding Disorders

Causes of bleeding disorders include:

• Von Willebrand disease
• Hemophilia
• Other clotting factor deficiencies
• Platelet disorders
• Disorders caused by anticoagulants (blood thinners)
• Obstetric complications associated with coagulopathy (such as placental abruption, preeclampsia or acute fatty liver of pregnancy)

Bleeding disorders may be diagnosed through blood tests or by clinical symptoms and signs.

Treatment of Bleeding Disorders during Pregnancy

• Treatment depends on the woman’s bleeding disorder, her overall health and her pregnancy. In general, treatment may include:
• Specialized care from a maternal-fetal medicine physician, an OB/GYN who specializes in high-risk pregnancies
• Frequent prenatal visits for close monitoring
• A carefully planned delivery, including anesthesia and delivery options that minimize the risk of bleeding
• Genetic counseling to evaluate the baby’s risk of an inherited bleeding disorder
• A multidisciplinary health care team, including a hematologist (a specialist in treating blood disorders), an anesthesiologist experienced in pregnancies with bleeding disorders, and a pediatric hematologist, pharmacy and blood bank, as needed
• Delivery at a state-of-the-art facility with the resources required to address serious bleeding problems

Benefits of Specialized Care

Texas Children’s Pavilion for Women offers specialized care for pregnancies involving bleeding disorders, optimizing safety and outcomes for mother and baby.

Benefits include:

• Preconception counseling to assess and reduce maternal and fetal risks prior to pregnancy
• Prenatal consultation, evaluation and treatment by a maternal-fetal medicine specialist trained and experienced in the management of these high-risk pregnancies
• Advanced imaging for early detection and treatment of complications
• Delivery at the Pavilion for Women’s leading-edge facility, equipped to respond to life-threatening complications and emergencies, including 24/7 access to blood products and transfusion services
• Seamless access to Texas Children’s Hospital and specialists for babies who need extra care and monitoring, including the Texas Children’s Fetal Center®, Texas Children’s Newborn Center®, and level IV neonatal intensive care unit (NICU)
• Expert genetic counseling and the latest testing technologies, through the Prenatal Genetics Clinic at Baylor College of Medicine, the largest of its kind in the United States
• A multidisciplinary, collaborative team of specialists experienced in addressing the needs of mothers and babies in pregnancies with bleeding disorders
• Close collaboration with your existing health care providers