{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T21:23:53Z","timestamp":1784755433627,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Managing pregnancy in carriers\/women with haemophilia involves four key objectives: preconception and prenatal care, minimizing maternal bleeding, choosing the delivery mode to reduce foetal\/neonatal bleeding, and postpartum care. The optimal factor VIII\/IX level at delivery and the best delivery method to mitigate maternal and foetal complications are still debated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To share real\u2010world clinical management in Italian haemophilia treatment centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In March\u2010April 2023, members of the Italian Association of Hemophilia Centers \u201cAICE\u201d were invited to an online survey to collect information on the management of pregnancy, delivery, and postpartum in carriers\/women with haemophilia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010three centres responded. Plasma FVIII\/FIX levels are systematically evaluated in the third trimester, considering a threshold above 50 U\/dL essential for safe delivery and neuraxial analgesia. Overall, the haematologic counselling on delivery mode generally aligns with obstetric indications in 73% of centres. In women who will give birth to a known affected male foetus, 55% rely on obstetric indication, while 24% suggest spontaneous delivery and 21% planned caesarean section. Excluding those which follow obstetric indication, natural delivery and planned caesarean section are recommended respectively by 40% and 60% when prenatal diagnosis is available or by 20% and 80% when not available. All centres agree to avoid instrumental delivery in affected male foetus or when prenatal diagnosis has not been made.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multidisciplinary pregnancy management is recommended. Delivery mode choice is primarily driven by ensuring the newborn's maximum protection. However, the use of caesarean section should also be weighted according to the mother's risk profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70097","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T16:24:28Z","timestamp":1753806268000},"page":"1015-1024","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of Pregnancy, Delivery, and Postpartum in Italian Carriers and Women With Haemophilia A and B"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5849-7377","authenticated-orcid":false,"given":"Silvia","family":"Linari","sequence":"first","affiliation":[{"name":"Center for Bleeding Disorders and Coagulation Careggi University Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berardino","family":"Pollio","sequence":"additional","affiliation":[{"name":"Regional Reference Center for Inherited Bleeding and Thrombotic Disorders Transfusion Medicine, \u201cRegina Margherita\u201d Children Hospital  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonietta","family":"Ferretti","sequence":"additional","affiliation":[{"name":"Center for Hemorrhagic and Thrombotic Diseases IRCCS A. Gemelli University Hospital Foundation  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8934-2936","authenticated-orcid":false,"given":"Mariasanta","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Maternal\u2010Childhood, Internal Medicine of Excellence G. D'Alessandro, University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Grandone","sequence":"additional","affiliation":[{"name":"Thrombosis and Hemostasis Unit, Fondazione IRCCS \u201cCasa Sollievo della Sofferenza  San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Siboni","sequence":"additional","affiliation":[{"name":"Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Brigida","family":"Aru","sequence":"additional","affiliation":[{"name":"Pediatric Onco\u2010Hematology Center \u201cMicrocitemico\u201d Hospital Cagliari  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Bertoni","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology and Bone Marrow Transplant (BMT) Unit, Children's Hospital, Spedali Civili  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Biasoli","sequence":"additional","affiliation":[{"name":"Hemophilia and Transfusion Center \u201cBufalini\u201d Hospital  Cesena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Cantori","sequence":"additional","affiliation":[{"name":"Hemophilia Center Department of Transfusion Medicine Hospital of Macerata  Macerata Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Di Gregorio","sequence":"additional","affiliation":[{"name":"Transfusion Medicine Department \u201cSS. Annunziata\u201d Hospital  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lassandro","sequence":"additional","affiliation":[{"name":"\u201cB. Trambusti\u201d General and Specialised Pediatrics Unit, \u201cGiovanni XXIII\u201d Hospital, University of Bari  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8833-1514","authenticated-orcid":false,"given":"Gianluca","family":"Sottilotta","sequence":"additional","affiliation":[{"name":"Hemophilia Center Grande Ospedale Metropolitano, Reggio Calabria  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Strangio","sequence":"additional","affiliation":[{"name":"Center for Hemorrhagic and Thrombotic Disorders Pugliese Ciaccio Hospital  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosaria","family":"Villa","sequence":"additional","affiliation":[{"name":"Hemophilia and Thrombosis Center Haematology Unit, \u201cOspedale del Mare\u201d Hospital  Naples 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