Hereditary hemorrhagic telangiectasia (HHT) is a genetic disease that is characterized by the presence of vascular malformations (VMs), such as birthmarks or growths, which can result in chronic bleeding, acute hemorrhage, and complications from shunting through VMs. In 2019, experts in HHT from the around the world came together to create a guideline to assist the estimated 1 in 5,000 patients living with this condition. One of the experts, who led the Pregnancy and Delivery group for the guideline, was Assistant Professor Dr. Andrea Lausman.
“For the first time, pregnancy and delivery in patients with HHT was addressed in a systematic fashion,” said Dr. Lausman. "Six key areas were highlighted and recommendations were made based on expert consensus of 80%, after systematic literature review. Most importantly for ObGyns, the recommendations include addressing preconception and prenatal diagnostic options; screening for brain and pulmonary VMs; treatment of pulmonary VMs in pregnancy; and recommendations for mode and location of delivery, as well as access to epidural anesthesia."
"This publication serves to address the most important questions asked by both patients with HHT and the clinicians caring for them," said Dr. Lausman. "Pregnancy is a time of great physiologic change and pregnant people with relatively rare, underlying health conditions need even greater medical attention through their pregnancies. However, these people may not live close to the tertiary care centre, and expert consultants may be difficult to access. These guidelines provide an international approach to the most common issues faced. Patients and clinicians can use this publication to guide their care and will allow them to receive expert level care and remain closer to home, with access to their support system."
Congratulations to Dr. Lausman and her team on this important guideline publication!