Hemophilia and Pregnancy

All parents and parents-to-be worry about the health of their children. During your pregnancy, you have probably followed a healthy pregnancy diet and made sure that your little one has gotten all the necessary vitamins and nutrients. But you may also need to worry about the possibility of passing on a genetic disorder to your baby. Hemophilia, a bleeding disorder, can be passed on from parent to child. Though rare, this disorder can prevent your child's blood from clotting, which can lead to a variety of complications.

What is Hemophilia?
Hemophilia is a hereditary bleeding disorder that prevents your blood from clotting properly. A person with hemophilia will bleed longer than usual after injury, and can lose large amounts of blood. A rare disease, hemophilia affects only about 18,000 people in the United States and every year, only 400 babies are born with the illness. However, hemophilia can be a dangerous disorder, as it can trigger internal bleeding in the muscles, soft tissues, joints, and vital organs.

What Causes Hemophilia?
Hemophilia occurs when you have low levels of clotting factor in your blood. Clotting factor is a protein that helps blood platelets stick together. When you get a cut, clotting factor helps to stop you from losing too much blood. People with hemophilia do not have enough of this clotting factor to stop blood loss. As a result, any injury, even small ones, can cause profuse internal or external bleeding.

Types of Hemophilia:
There are two main types of hemophilia:

 

• Hemophilia A: Hemophilia A, also known as classic hemophilia, is the most common type of hemophilia. It is caused by low levels of Factor VIII protein in the blood.
• Hemophilia B: Hemophilia B, also referred to as Christmas Disease, is much more rare. It is caused by low levels of Factor IX protein in the blood.

 

Who Gets Hemophilia?
Hemophilia is a hereditary disease, so it mostly passed down through families. The disorder generally affects males, however, it is possible for females to get hemophilia, though it is very uncommon. Boys and girls can also become carriers of the disease at conception.

Hemophilia is passed on through a genetic defect. This defect is linked with the X chromosome, and thus it affects boys much more often then girls. If a mother is a carrier of the hemophilia gene, there is a 50% chance that her son will get the disease and a 50% chance that her daughter will be a carrier. Women can only get the disease if their father is a hemophiliac and their mother is a carrier, which is extremely rare.

About 30% of hemophiliacs develop the disease through a genetic mutation that takes place during conception. This means that a large number of hemophiliacs actually have no genetic history of the disease.

Symptoms of Hemophilia
The main symptoms of hemophilia are bruising and bleeding that won�t stop. Symptoms do tend to change as you get older, with children experiencing more severe symptoms.

 

Hemophilia symptoms in infants include:

 

• bruised and bleeding gums, especially during teething
• frequent bumps and bruises when learning to walk
• swelling of the joints, muscles, and soft tissue

 

Symptoms of hemophilia in older children and adults include:

 

• bleeding in the joints, especially the knees, ankles, and elbows
• bleeding in the muscles and soft tissue
• frequent and unexplained nosebleeds
• bloody urine
• bloody stools

 

Complications Associated with Hemophilia
Hemophilia disease can be very problematic especially if it is severe. Severe hemophiliacs often suffer from internal injuries that apparently have no cause, resulting in bleeding in the joints and muscles. Untreated hemophilia can result in:

 

• Joint Damage: When bleeding in the joints occurs, each joint becomes swollen, inflamed, and unable to move. This can cause permanent joint damage, limiting range of motion and flexibility. The more joint bleeds a person suffers from, the more likely he is of having permanent joint damage.
• Bleeding in the Neck: If blood begins to seep into the neck or throat, it could block your airway, making breathing difficult. This can become life threatening.
• Brain Bleeds: Hemophiliacs can suffer from brain bleeds, in which blood seeps into the brain. This can cause severe brain damage and even death. Watch for signs including: vomiting, seizures, dizziness, double vision, and neck stiffness.

 

Screening for Hemophilia
If you are pregnant or thinking about becoming pregnant, you may want to have yourself screened for the hemophilia gene. Genetic and chromosomal screening tests are available to expectant couples. These can determine if you or your partner is a carrier of hemophilia. This test is a simple blood test that is more than 95% accurate. Having this test may help you to decide if you want to have anymore children and it can also prepare you for raising a child that may have hemophilia.

Hemophilia Treatment
Unfortunately, there is no cure for hemophilia and treatment for the disorder cannot be performed in utero. However, with treatment after birth, the majority of hemophiliacs go on to live long and fulfilling lives. Treatments include:

 

Replacement Therapy: Replacement therapy involves injecting clotting factor back into the bloodstream. Clotting factor, which is created artificially or taken from blood donors, can be given on a regular basis to hemophiliacs. This can help to prevent bleeding. Clotting factor can also be given when bleeding occurs to help induce clotting.

 

Desmopressin (DDAVP): Desmopressin is a synthetic hormone used to help treat mild or moderate hemophilia A. Desmopressin works by triggering the release of Factor VIII, helping blood to clot more easily. Desmopressin can be injected or administered through a nasal spray.

Antifibrinolytic Drugs: Antifibrinolytic drugs are used to prevent clots from breaking down. These medications are often given to hemophiliacs who are undergoing dental or other types of surgeries, or who experience mild intestinal or nasal bleeding.