Pregnancy and HHT
Jacinta Byrne | Shares her presentation on HHT & Pregnancy
Jacinta is a registered Nurse and Midwife, having worked in both the hospital and community settings in the UK and Ireland.
She spent the last 22 years working in the National Maternity Hospital where she became a registered prescriber, lecturer, and an Advanced Practitioner in Clinical Haematology. This is where she developed her interest in HHT.
She is currently working in Mayo University Hospital as a Clinical Midwife Manager 3.
We were so lucky to have Jacinta present at our 2023 Patient Forum.
We attach her powerpoint presentation below for you to download and enjoy.
VASCERN is the European Reference Network established in 2017, aiming at improving and homogenising care of patients with rare multi-systemic vascular diseases throughout Europe.
Learn how to manage a pregnancy with Hereditary Haemorrhagic Telangiectasia, including detailed discussions of risks such as Pulmonary and Hepatic arteriovenous malformations.
Planning to have a baby?
Any woman planning to have a child has a lot of questions, but those living with a chronic disorder such as HHT need even more reassurance and clear answers.
According to the Health Service Executive (HSE), a chronic illness is defined as a long term condition which can be treated but not cured.
Hereditary Haemorrhagic Telangiectasia (HHT) affects 1 in 5000 people and it is an autosomal dominant genetic disorder. That means that each child born of an HHT parent has a 50/50 chance of inheriting the gene. The sex of the child is irrelevant. Men and women are affected with HHT in equal numbers.
Is Pregnancy considered high risk
Pregnancy in patients with HHT is considered high risk. This is due to the possibility of life threatening complications.
Women with HHT appear to be most vulnerable to complications in the second and third trimesters due to physiological adaptations which occur in pregnancy.
However, it’s important to know that most women living with HHT have a normal pregnancy without developing any complications due to the disorder.
An essential consultation before pregnancy
It is recommended for the future mother to see a doctor prior to the conception. This allows a check up before the birth of a child and ensures a good following up. The consultation can usually be performed by the attending doctor, who knows about HHT.
It is essential to follow certain preventive measures recommended before and during pregnancy.
It is essential for women planning to be pregnant to do a screening for pulmonary AVMs.
Screening and treatment, if necessary, should be done before pregnancy.
It is important to check the absence of spinal AVMs before or during pregnancy if epidural anaesthesia is planned.
About the screenings during the pregnancy
It is highly advised not to do any screening during pregnancy, unless there is a strong clinical suspicion of pulmonary AVM.
Treatment and follow-up adapted to each case
If you are under medication, it may be necessary to review the prescription of drugs in order to preserve the health of the baby. Your doctor will make sure that the treatment is compatible with the pregnancy and will advise what is best suited for the foetus.
While three ultrasounds are done in a normal pregnancy, women with a chronic illness may have one per month. This will not affect the proper development of the foetus since the ultrasound used on pregnant women is not considered dangerous.
Check the process in your local area.
Birth, when baby shows up
A vaginal birth should be favoured, with a second phase of labour shortened if a cerebral AVM has not been excluded.
Also, antibiotic prophylaxis and venous air filters are indicated if pulmonary AVM has not been ruled out.