We report a confirmed case of pregnancy-associated acquired hemophilia A identified during preoperative evaluation for cesarean delivery. Although immunosuppressive therapy is generally recommended to eradicate factor VIII inhibitors, urgent delivery was required because of pregnancy-induced hypertension complicated by nephropathy. Under these circumstances, a cesarean delivery was performed without previous immunosuppressive treatment. Intraoperative hemostasis was well controlled, and both maternal and neonatal outcomes were favorable. This report may assist in clinical decision-making when invasive procedures are required in patients with acquired hemophilia A before therapeutic intervention with immunosuppressive therapy can be initiated.
Yamamoto et al. (Fri,) studied this question.