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Gynaecological issues in women with bleeding disorders: CSL Behring Symposium Cover

Gynaecological issues in women with bleeding disorders: CSL Behring Symposium

The Journal of Haemophilia Practice
Volume 6 (2019): Issue 2 (January 2019)
By: Angelika Batorova,  Karin van Galen,  Sylvia von Mackensen,  Ioannis Tsimpanakos and  Evelyn Grimberg  
Open Access
|Oct 2019

Figures & Tables

Figure 1A

Obstetric and gynaecological-related surgeries in women with VWD in Slovakia, 1998–2018
Obstetric and gynaecological-related surgeries in women with VWD in Slovakia, 1998–2018

Figure 1B

Obstetric and gynaecological-related surgeries in women with FVII deficiency in Slovakia 1998–2019
Obstetric and gynaecological-related surgeries in women with FVII deficiency in Slovakia 1998–2019

Figure 2

Impact of heavy menstrual bleeding on overall life activities in women with von Willebrand disease (% affected, n=22) [23]
Impact of heavy menstrual bleeding on overall life activities in women with von Willebrand disease (% affected, n=22) [23]
Ovulation bleeding occurs in up to 30% of women, but women with bleeding disorders are at risk from excessive bleeding. In a normal menstrual cycle, ovulation occurs during the second week, coinciding with a trough in the cyclic variation of von Willebrand factor.© Shutterstock
Ovulation bleeding occurs in up to 30% of women, but women with bleeding disorders are at risk from excessive bleeding. In a normal menstrual cycle, ovulation occurs during the second week, coinciding with a trough in the cyclic variation of von Willebrand factor.© Shutterstock
Evelyn Grimberg, who has Glanzmann’s thrombasthenia, advocates a team approach to preparing for surgery for women with bleeding disorders. The woman herself should be involved, alongside the surgeon, anaesthetist, haematologist and her treatment centre.
Evelyn Grimberg, who has Glanzmann’s thrombasthenia, advocates a team approach to preparing for surgery for women with bleeding disorders. The woman herself should be involved, alongside the surgeon, anaesthetist, haematologist and her treatment centre.

Women’s personal experiences of surgery

“I need surgery and got my treatment plan. This one is different from the last one. I’m worried if everything will go well”“Surgery went well, but I had a bleed afterwards when I was back home. I got hospitalised again”“My physician was too scared of bleeds during surgery, so he decided not to perform surgery”“I had surgery but they didn’t consult my haematologist”“They almost gave me painkillers with blood thinners”

Dosage and monitoring recommendations for patients with VWD undergoing surgery [4,6,7]

MAJOR SURGERYMINOR SURGERY
Loading dose VWF:RCo40–60 IU/kg30–60 IU/kg
Target level for surgeryVWF: RCo and FVIII 100 IU/dLVWF: RCo and FVIII ≥80 IU/dL
Maintenance dose VWF:RCo20–40 IU/kg every 8–24 hours20–40 IU/kg every 12–24 hours
Sustained post-OP troughs of VWF:RCo and FVIII>50 IU/dL for 7–14 days>50 IU/dL for 3–5 days
Monitoring FVIII and VWF:RCotroughs and peaks dailytrough and peak at least once
Safety parameterVWF:RCo <200 and FVIII<200-300 IU/dL
DOI: https://doi.org/10.17225/jhp00142 | Journal eISSN: 2055-3390
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Language: English
Page range: 28 - 38
Published on: Oct 21, 2019
Published by: Haemnet Ltd
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
Women with bleeding disorders,
von Willebrand disease,
factor VII deficiency,
surgery,
Slovakia,
ovulation bleeding,
health-related quality of life,
pelvic pain,
patient experience
Related subjects:
Medicine,
Basic medical science,
Basic medical science, other,
Clinical medicine,
Clinical medicine, other,
Pharmacy,
Pharmacology

© 2019 Angelika Batorova, Karin van Galen, Sylvia von Mackensen, Ioannis Tsimpanakos, Evelyn Grimberg, published by Haemnet Ltd
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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