Departments of Paediatrics and Coagulation Disorders, Lund University, University Hospital, Malmö, Sweden.
Haemophilia. 2010 May;16(3):415-9. doi: 10.1111/j.1365-2516.2009.02144.x. Epub 2009 Nov 18.
The optimal mode of delivery of a haemophilia carrier expecting a child is still a matter of uncertainty and debate. The aim of this commentary/review is to suggest that normal vaginal delivery should be the recommended mode of delivery for the majority of carriers, based on review of studies on obstetric aspects of haemophilia. About 2.0-4.0% of all haemophilia boys born in countries with a good standard of health care will suffer from ICH during the neonatal period. This is an average figure including all modes of delivery and regardless of whether the carrier status of the mother or the haemophilia status of the foetus was known or not at the time of delivery. On the basis of current literature, one may conclude that the risk of serious bleeding in the neonate affected with haemophilia is small in conjunction with normal vaginal delivery. It should be possible to further reduce the low frequency of complications if appropriate precautions are taken when planning the delivery in pregnant woman with known carrier status, if the sex of the foetus is known and, even more, when the haemophilia status of the foetus is known. Instrumental delivery such as use of vacuum extraction and foetal scalp monitors must be avoided at delivery of carriers.
期待生育子女的血友病携带者的最佳分娩方式仍然存在不确定性和争议。本评论/综述的目的是基于对血友病产科方面研究的回顾，建议大多数携带者应选择正常阴道分娩。在医疗保健水平良好的国家，约有 2.0-4.0%的所有血友病男孩在新生儿期会发生 ICH。这是一个平均数字，包括所有分娩方式，无论在分娩时母亲的携带者状态或胎儿的血友病状态是否已知。根据目前的文献，我们可以得出结论，在正常阴道分娩的情况下，患有血友病的新生儿严重出血的风险很小。如果在已知携带者状态的孕妇分娩计划中采取适当的预防措施，如果已知胎儿的性别，甚至当已知胎儿的血友病状态时，可以避免器械分娩（如使用真空吸引和胎儿头皮监测器），那么可以进一步降低低频率的并发症。
