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Thrombosis in a Pregnant Hemophilia A Carrier After Intrapartum Recombinant Factor VIII

Russell, Zoi MD; Riconda, Dan MS; Pollack, Lynda MD; O'Leary, Timothy D. MD; Carlan, S J. MD

doi: 10.1097/01.AOG.0000141648.05771.24
Case Report

BACKGROUND: Symptomatic hemophilia A is a rare disorder in females. Pregnancy and delivery in such women can be life threatening. Obstetric management is challenging and requires a multidisciplinary approach to ensure a good outcome.

CASE: A woman with hemophilia A delivered by cesarean developed a deep vein thrombosis 10 days postpartum after recombinant factor VIII administration.

CONCLUSION: Hemophilia A due to skewed X-inactivation is a rare cause of peripartum bleeding. Recombinant factor VIII administration can prevent hemorrhage during and after cesarean delivery but may be associated with development of deep vein thrombosis.

Recombinant factor VIII can prevent hemorrhage in manifesting carriers of hemophilia A undergoing cesarean delivery.

Department of Obstetrics and Gynecology, Arnold Palmer Hospital for Children and Women, Orlando Regional Healthcare, Orlando, Florida

Address reprint requests to: Zoi Russell, MD, 105 West Miller Street, Orlando, Florida 32806; e-mail:

Received January 30, 2004. Received in revised form April 8, 2004. Accepted April 29, 2004.

© 2005 The American College of Obstetricians and Gynecologists