Dunkley Scott M, Russell Susan J, Rowell John A, Barnes Chris D, Baker Ross I, Sarson Megan I, Street Alison M
Institute of Haematology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Med J Aust. 2009 Oct 19;191(8):460-3. doi: 10.5694/j.1326-5377.2009.tb02887.x.
Pregnancy and delivery are critical times for women with bleeding disorders, with mothers, and possibly their affected infants, being exposed to a variety of haemostatic challenges. Management of women with bleeding disorders during pregnancy involves a multidisciplinary team including, but not limited to, an obstetrician, an anaesthetist and a haematologist. This consensus document from the Australian Haemophilia Centre Directors' Organisation (AHCDO) provides practical information for clinicians managing women with bleeding disorders during pregnancy. Included are: the expected physiological response in pregnancy in such women; management of pregnancy, labour and delivery, as well as obstetric anaesthesia issues, postpartum care, and reducing and treating postpartum haemorrhage; and management of infants at risk of a bleeding disorder and of bleeding in neonates. The guidelines were developed after extensive consultation, face-to-face meetings and revisions. The final document represents a consensus opinion of all AHCDO members. Where evidence is lacking, recommendations are based on clinical experience and consensus opinion.
对于患有出血性疾病的女性来说，怀孕和分娩是关键时期，母亲以及可能受影响的婴儿会面临各种止血挑战。孕期患有出血性疾病的女性的管理需要一个多学科团队，包括但不限于产科医生、麻醉师和血液科医生。这份来自澳大利亚血友病中心主任组织（AHCDO）的共识文件为临床医生管理孕期患有出血性疾病的女性提供了实用信息。内容包括：此类女性孕期的预期生理反应；妊娠、分娩和接生的管理，以及产科麻醉问题、产后护理，减少和治疗产后出血；以及对有出血性疾病风险的婴儿和新生儿出血的管理。这些指南是在广泛咨询、面对面会议和修订后制定的。最终文件代表了所有AHCDO成员的共识意见。在缺乏证据的情况下，建议基于临床经验和共识意见。
