Gynaecological and obstetrical problems in women with different bleeding disorders

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Abstract:

Summary. 

The aim of this case–control study was to analyse the prevalence of gynaecological, obstetrical and other more general bleeding symptoms in 114 women affected by various inherited bleeding disorders, who were compared with 114 apparently healthy women. Retrospective information were collected by means of two specific questionnaires, one on gynaecological and obstetrical bleeding symptoms, with special focus on the presence of menorrhagia as defined by a pictorial blood loss assessment chart (PBAC); and the other on general bleeding symptoms, whose severity was graded by means of the bleeding score (BS). Compared to normal women, the whole group of women with inherited bleeding disorders had a higher prevalence of excessive bleeding at menarche (25% vs. 5%, P < 0.0001) and menorrhagia (59% vs. 46%, P = 0.06). Affected women also had a higher frequency than controls of general bleeding symptoms that scored as severe by a BS ≥ 12 (49% vs. 0%, P < 0.0001). In affected women, the BS increased according to the severity of the haemostasis defect. In conclusions, the BS and the PBAC are simple tools to evaluate the severity of general bleeding symptoms and menorrhagia in women with inherited bleeding disorders. These instruments may help to identify those women for whom a therapeutic intervention is warranted.

Keywords: haemophilia; menorrhagia; pregnancy; rare bleeding disorders; von Willebrand disease

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-2516.2009.02072.x

Affiliations: 1: Gynaecological and Obstetrical Division, Azienda Ospedaliera Ospedale Civile di Vimercate, Presidio Ospedaliero di Carate Brianza, Carate Brianza, Italy 2: Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, University of Milan and Department of Medicine and Medical Specialties, IRCCS Maggiore Hospital, Mangiagalli and Regina Elena Foundation, Lugi Villa Foundation, Milan, Italy

Publication date: November 1, 2009

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