Mode of delivery and risk of intracranial haemorrhage in newborns with severe haemophilia A: A multicentre study in Gulf region

H. F. Nazir, T. Al Lawati, I. Beshlawi, S. Alsharidah, M. Elshinawy, F. Alkasim, M. F. Khanani, A. Tarawa, T. Al Subhi, A. Alrawas, W. Al Riyami, S. Al Kindi, K. Al Saadi, S. Al-Lamki, Y. Wali*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Introduction: The optimum mode of delivery in a known carrier of a haemophilia A is still an issue of debate. Aim: This study was conducted to report a multicentre experience in Gulf Cooperation Council (GCC) on the incidence of intracranial haemorrhage (ICH) in newborns with severe haemophilia A delivered by different modalities. Methods: We have conducted a retrospective/prospective multicentre cohort study including a total of seven hospitals distributed in four GCC countries between 1998 and Jan 2015. A total of 163 patient with severe haemophilia A (factor VIII <1%) were enrolled in this study, age ranged between 2 weeks to 18 years. Results: Most of the patients were born by spontaneous vaginal delivery (SVD) (131, 80.4%), whereas 26 patients (16%) were born by CS and only six patients were born by instrumental delivery (3.7%), five of them by vacuum and one was delivered using forceps. Five out of 163 patients developed ICH during the first 2 weeks of life (3.1%). Two of them were born by SVD (2/131; 1.5%) and two were born by instrumental delivery (2/6; 33.3%). Only one patient among those who were born by caesarean section developed ICH (1/26; 3.8%). Assisted vaginal delivery was associated with a significant risk of ICH, in comparison to SVD and CS (P = 0.0093). Conclusion: Normal vaginal delivery is still considered a safe journey through the birth canal for haemophilic newborns particularly in this area of the world. Larger prospective studies might be needed to define an evidence-based optimal mode of delivery for the haemophilia carrier expecting an affected child.

Original languageEnglish
Pages (from-to)e134-e138
JournalHaemophilia
Volume22
Issue number3
DOIs
Publication statusPublished - May 1 2016
Externally publishedYes

Keywords

  • Gulf region
  • Haemophilia A
  • Intracranial haemorrhage
  • Mode of delivery

ASJC Scopus subject areas

  • Hematology
  • Genetics(clinical)

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