Acquired hemophilia A in women postpartum: clinical manifestations, diagnosis, and treatment.

Acquired hemophilia A in women postpartum is diagnosed by a prolonged activated partial thromboplastin time (APTT), low plasma levels of coagulant factor VIII, and the detection of an inhibitor against factor VIII in the Bethesda assay. Effective treatment of bleeding symptoms should be based upon the clinical situation and depends on the inhibitor characteristics against human and porcine factor VIII. Immunosuppression usually does not significantly affect the disappearance of the factor VIII inhibitor antibody. The natural history of acquired hemophilia postpartum is independent of immunosuppressive treatment and featured by spontaneous disappearance of the inhibitor against factor VIII in the majority of cases.