What is the optimal mode of delivery for the haemophilia carrier expecting an affected infant-vaginal delivery or caesarean delivery?

摘要

In the spirit of a traditional debate, the editors have invited eminent authors to present differing views on the optimum mode of delivery in carriers expecting a baby known to be suffering from or at risk of haemophilia. Andra James and her colleagues propose caesarean section whilst Rolf Ljung proposes vaginal delivery [1,2]. They review risks and benefits to mother and baby in developing their opposing arguments. Genetic counselling, phenotypic testing of carriers and more recently genetic mutation analysis are well integrated into the delivery of comprehensive haemophilia care. Prenatal diagnosis, although informative to the management of delivery of an affected baby, is not a routine practice, and sporadic haemophilia accounts for one-third to one-half of all cases of haemophilia [3].