Are there any precautions a carrier should take if she becomes pregnant?

It is important that a carrier’s hematologist is involved in the supervision of the pregnancy and that there is some liaison with the obstetrician before delivery. It is not necessary to perform prenatal diagnosis just for management of the pregnancy. This is only done if termination of a pregnancy is being considered.

The factor VIII level (but not factor IX) tends to rise during pregnancy but it should be checked sometime in the last couple of months of pregnancy.

A normal vaginal delivery is perfectly acceptable even if the foetus is known to be male and at risk of haemophilia. Epidural anesthesia does not usually present a problem and is generally permissible if the patient’s factor level is 40 percent or more. A cord blood sample after delivery will be used to check if a male baby has haemophilia.

What is acquired haemophilia?
In rare cases, a person can develop haemophilia later in life. The majority of cases involve middle-aged or elderly people, or young women who have recently given birth or are in the later stages of pregnancy.

Acquired haemophilia is usually caused by the development of antibodies to factor VIII (the body’s immune system destroys its own naturally produced factor VIII).

This condition often resolves with appropriate treatment, which typically involves a combination of steroid treatment and the drug cyclophosphamide.