Labour and delivery | o Vaginal delivery or caesarean section o Minimalise risk of bleeding/haemorrhage- avoid prolonged labour o No vaccum o No forceps o No fetal scalp elecrodes o No fetal blood samping o Post-delivery screening of VIII clotting factor (umbilical cord) o No invasive procedures till results. | |
Ventilation | o non-invasive and mechanical ventilation (all modes) if required o focus on nose care | |
Central venous catheter | o factor replacement prior to procedure | [3] |
Pawilizumab | o intramuscular injection o factor replacement prior to vaccination o application of ice to the injection site o compression at the injection site | [31] |
Vaccination | o vaccinations (mandatory and recommended) according to institutional vaccination schedule o subcutaneous administration preferred o application of ice to the injection site o thinnest possible needle | [31] |
Pain | o minimalisation of invasive procedures o cumulation of prcedures o no nonsteroidal anti-inflammatory drugs (NSAIDs) or acetylsalicylic acid (ASA) o usage of acetaminofen, morphine o tramadol, codeine, ketamine, fentanyl | [3] |
Surgical procedures | o pre-operative inhibitor (anti- FVIII antibodies) screening o factor replacement therapy prior to procedure (or in case of presence of FVIII antibodies-therapy with by-passing coagulation agents) o reservation of VIII coagulation factor or by-passing agents for the surgery and postoperative time, rehabilitation o re-screen level of anti- FVIII antibodies after surgery o surgical procedures at or in consultation with a comprehensive hemophilia treatment centre. | [3] |
PDA ligation | o usage of paracetamol, o avoid ibuprofen |