Successful management of acquired hemophilia A onset during pregnancy: A case report

J Obstet Gynaecol Res. 2021 Nov;47(11):4060-4066. doi: 10.1111/jog.14938. Epub 2021 Jul 14.

Abstract

Acquired hemophilia A (AHA) is a rare bleeding disorder caused by autoantibodies that inhibit coagulation factor VIII. Pregnancy could be associated with AHA in younger women. Because of its rarity, the optimal management for pregnancy-related AHA has not yet been established. Herein, we present the case of a 32-year-old woman with AHA diagnosed during pregnancy because of elevated activated partial prothrombin time, decreased factor VIII activity, and the presence of a factor VIII inhibitor. She was treated with immunosuppressive therapy consisting of corticosteroid and cyclosporine administration. Although complete remission could not be induced in the peripartum period, she gave birth safely by cesarean delivery in combination with prophylactic bypass hemostatic therapy. This work would provide helpful information to guide better recognition and treatment of pregnancy-related AHA cases.

Keywords: acquired hemophilia A; bypass hemostatic therapy; corticosteroid; cyclosporin; pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones
  • Adult
  • Autoantibodies
  • Female
  • Hemophilia A* / diagnosis
  • Hemophilia A* / drug therapy
  • Hemorrhage
  • Hemostatics*
  • Humans
  • Pregnancy

Substances

  • Adrenal Cortex Hormones
  • Autoantibodies
  • Hemostatics