Target Audience
This activity has been designed to meet the educational needs of hematologists, surgeons, obstetrician-gynecologists, anesthesiologists, and registered nurses involved in the management of patients with postpartum acquired hemophilia.


Statement of Need
Postpartum hemorrhage is a major cause of maternal morbidity and mortality worldwide, occurring in up to 18% of births. Acquired hemophilia A is a rare but serious bleeding diathesis caused by autoantibodies directed against factor VIII. The postpartum development of an inhibitor against factor VIII is an uncommon but potentially life-threatening complication of pregnancy. Because inhibitors may occur in otherwise healthy pregnant women with no history of uncontrolled bleeding, timely diagnosis is essential to optimal outcome. This educational activity affords healthcare professionals the opportunity to become familiar with the clinical manifestations of postpartum hemorrhage caused by factor VIII inhibitors and learn appropriate treatment strategies for managing the condition from an expert in blood disorders.


Purpose/Goal Statement
The purpose of this activity is to provide updated information on how to manage postpartum acquired hemophilia.


Educational Objectives
After completing this activity, the participant should be better able to:

• Differentiate acquired hemophilia from other coagulation disorders in the postpartum period
• Identify the clinical manifestations of postpartum hemorrhage caused by factor VIII inhibitors
• Explain the role of lab studies in the diagnosis of postpartum acquired hemophilia
• Outline treatment strategies for the management of patients with postpartum acquired hemophilia

Distinguished Faculty
Michael J. Paidas, MD
Associate Professor and Co-Director
Yale Women and Children's Center for Blood Disorders
Yale School of Medicine
New Haven, Connecticut


Physician Continuing Medical Education
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM), the Cardiovascular & Metabolic Health Foundation, and Educational Concepts in Medicine. PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Postgraduate Institute for Medicine designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


Nursing Continuing Education
Accreditation Statement
CNA/ANCC
This educational activity for 0.6 contact hours is provided by Postgraduate Institute for Medicine (PIM).

PIM is an approved provider of continuing nursing education by the Colorado Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

California Board of Registered Nursing
Postgraduate Institute for Medicine is approved by the California Board of Registered Nursing, Provider Number 13485, for 0.6 contact hours.


Method of Participation
During the period January 30, 2009 through January 30, 2010, participants must:

• Read the learning objectives and faculty disclosures
• Study the educational activity
• Complete the posttest by recording the best answer to each question
• Complete the evaluation form

A statement of credit will be issued upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.


Fee
There is no fee to participate in or to receive credit for this educational activity.


Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Name of Faculty or Presenter	Reported Financial Relationship
Michael J. Paidas, MD	Advisory Board Member: CSL Behring, Novo Nordisk Inc. Contracted Research: Novo Nordisk Inc.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Name of Planner or Manager	Reported Financial Relationship
PIM Clinical Reviewers: Trace Hutchison, PharmD; Jan Hixon, RN, BSN, MSN; Linda Graham, RN, BSN; and Jan Schultz, RN, BSN, MSN	Have no real or apparent conflicts of interest to report.
ECM: Bart Zoni, Executive Director; Gay Boyle, Editorial Services	Have no real or apparent conflicts of interest to report.

Media
Internet

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM), Cardiovascular & Metabolic Health Foundation (CMH), Educational Concepts in Medicine, and Novo Nordisk Pharmaceuticals do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, CMH, Educational Concepts in Medicine, and Novo Nordisk Pharmaceuticals. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.


Commercial Support
This activity is supported by an educational grant from Novo Nordisk Pharmaceuticals.