Studies were excluded if DDAVP was used for treatment of OSI-906 manufacturer diabetes insipidus or in nonpregnant women. From the studies that met the selection criteria, the following information was extracted and tabulated: the author

and year of publication, underlying bleeding disorder, indication and stage of pregnancy at which treatment with DDAVP was initiated, dose of DDAVP and any other treatment given, clinical and relevant laboratory haemostatic values, mode of delivery, maternal side effects and neonatal outcome. Two reviewers (IS and PP) independently extracted data from the included articles. Evaluation of eligibility for inclusion of the extracted articles was performed by a third reviewer (RK). Using the search criteria above, 30 studies were found eligible for inclusion in this review. The main clinical characteristics

of these are summarized in Tables 1–3. There were a total of 216 pregnancies included in these studies: eight prospective studies with a total of 111 pregnancies (Table 1) [7–14] and six retrospective studies with a total of 85 pregnancies (Table 2) [15–20]. The most common study design case report, which accounted for 16 of the studies and 20 of the total pregnancies (Table 3) [3,5,21–34]. The most common bleeding disorder reported by these studies was ICG-001 order VWD with 168 pregnancies followed by carriers of haemophilia A with 31 pregnancies reported. DDAVP was used in 12 pregnancies with disorders of platelet function including 上海皓元医药股份有限公司 Bernard–Soulier syndrome (three pregnancies), Hermansky–Pudlak Syndrome (four pregnancies), storage pool disorder (three pregnancies) and unspecified functional platelet disorders (two pregnancies). Other disorders with reported DDAVP use were acquired factor VIII inhibitors (three pregnancies) and Ehlers–Danlos

syndrome (two pregnancies). Dosing regimes for DDAVP were mostly based on patient weight with an intravenous infusion of 0.3 μg kg−1 DDAVP being the most commonly used (166 cases). Other intravenous dosing regimes were 0.4 μg kg−1 (five cases), 0.2 μg kg−1 (one case), 12 μg (one case) and 20 μg (one case). Intranasal DDAVP was used in two studies (33 cases) at a dose of 300 μg and in nine cases the dose of DDAVP was not recorded. Desmopressin was used during the first and early second trimester in 51 pregnancies. DDAVP was reported for prevention of bleeding prior to invasive procedures including chorionic villus sampling (20 cases), amniocentesis (12 cases), cervical cerclage (four cases) and termination of pregnancy (14 cases) [8,15,24]. All these procedures had successful outcomes without significant complication or bleeding. DDAVP was also used as treatment for bleeding complications in one case of first trimester retroplacental haematoma [15]. There were no reported neonatal complications reported in those pregnancies that were carried to term. Maternal side effects associated with DDAVP were recorded in one study and were generally mild and included facial flushing and headache [8].