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Thromb Haemost 2011; 106(05): 885-892
DOI: 10.1160/TH11-03-0180
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Gynaecological and obstetric bleeding in moderate and severe von Willebrand disease

Eva M. de Wee
1   Hematology, Erasmus University Medical Center Rotterdam, Netherlands
,
H. Marieke Knol
2   Hematology, University Medical Center Groningen, Netherlands
3   Gynaecology, University Medical Center Groningen, Netherlands
,
Eveline P. Mauser-Bunschoten
4   Van Creveldkliniek and Hematology, University Medical Center Utrecht, Netherlands
,
Johanna G. van der Bom
5   Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Netherlands
6   Department of Clinical Epidemiology, Leiden University Medical Center, Netherlands
,
Jeroen C. J. Eikenboom
5   Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Netherlands
7   Thrombosis and Hemostasis, Leiden University Medical Center, Netherlands
,
Karin Fijnvandraat
8   Pediatric Hematology, Emma Children’s hospital AMC, Amsterdam, Netherlands
,
Arja de Goede-Bolder
9   Pediatrics, Erasmus MC, Sophia Children’s hospital, Rotterdam, Netherlands
,
Britta Laros-van Gorkom
10   Hematology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
,
Paula F. Ypma
11   Hematology, HagaZiekenhuis, The Hague, Netherlands
,
Sonja Zweegman
12   Hematology, VU University Medical Center, Amsterdam, Netherlands
,
Karina Meijer
2   Hematology, University Medical Center Groningen, Netherlands
,
Frank W. G. Leebeek
1   Hematology, Erasmus University Medical Center Rotterdam, Netherlands
,
for the WiN study group › Author Affiliations
Further Information

Publication History

Received: 17 March 2011

Accepted after major revision: 29 July 2011

Publication Date:
23 November 2017 (online)

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Summary

A nation-wide cross-sectional study was initiated to assess gynaecological and obstetrical symptoms in an unselected cohort of women with moderate and severe von Willebrand disease (VWD) in the Netherlands. A total of 423 women aged ≥16 years were included. Bleeding severity was measured using the Tosetto Bleeding Score (BS). Menorrhagia, defined as occurrence of ≥2 menorrhagia symptoms, was reported by 81%. Of all VWD women, 78% received any kind of treatment for menorrhagia and 20% underwent a hysterectomy predominantly because of severe menstrual bleeding. Over half of the women reported more blood loss than can be expected with a normal delivery. In 52% of reported pregnancy losses curettage was needed because of bleeding. Mean number of live births was 1.9, which is comparable with the general Dutch population. In conclusion, women with moderate or severe VWD frequently have menorrhagia in need of treatment, and 20% of the VWD women underwent a hysterectomy. Bleeding complications occurred in over 50% of the women after childbirth or pregnancy loss. Progeny seems not to be affected in women with moderate or severe VWD.

Keywords

Bleeding - menorrhagia - postpartum haemorrhage - von Willebrand disease - hysterectomy
 

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