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Gynaecological and obstetrical problems in women with different bleeding disorders
S M Siboni1, M Spreafico, L Calò
1Angelo 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.
Summary
Women with inherited bleeding disorders experience more frequent gynaecological bleeding, including menorrhagia, and general bleeding symptoms. The bleeding score (BS) and pictorial blood loss assessment chart (PBAC) effectively assess symptom severity.
Area of Science:
- Haematology
- Gynaecology
- Obstetrics
Background:
- Inherited bleeding disorders are associated with various bleeding symptoms.
- Gynaecological and obstetrical bleeding complications are common in affected women.
- Standardized tools are needed to assess bleeding symptom severity.
Purpose of the Study:
- To analyze the prevalence of gynaecological, obstetrical, and general bleeding symptoms in women with inherited bleeding disorders.
- To compare symptom prevalence between affected women and healthy controls.
- To evaluate the utility of the bleeding score (BS) and pictorial blood loss assessment chart (PBAC) in assessing symptom severity.
Main Methods:
- Case-control study involving 114 women with inherited bleeding disorders and 114 healthy controls.
- Retrospective data collection using two specific questionnaires.
- Assessment of gynaecological/obstetrical bleeding (including menorrhagia via PBAC) and general bleeding symptoms (via BS).
Main Results:
- Women with inherited bleeding disorders showed a higher prevalence of excessive bleeding at menarche (25% vs. 5%) and menorrhagia (59% vs. 46%).
- Severe general bleeding symptoms (BS ≥ 12) were significantly more frequent in affected women (49% vs. 0%).
- Bleeding score severity correlated with the underlying haemostasis defect in affected women.
Conclusions:
- The BS and PBAC are effective tools for evaluating general bleeding symptoms and menorrhagia severity in women with inherited bleeding disorders.
- These instruments can help identify women requiring therapeutic intervention.
- Early identification and management of bleeding symptoms are crucial for affected women.
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