[Diagnostics on suspicion of a bleeding disorder]

Bleeding symptoms occur frequently in the general population, but the possibility of an underlying bleeding disorder is not always recognised. Women with a bleeding disorder are disproportionally affected due to blood loss during menstruation and giving birth. Taking a thorough family history and a history of bleeding are most important in the workup to detect a potential underlying bleeding disorder. In patients with a bleeding disorder, potentially life-threatening complications due to bleeding can be prevented by compiling an individualized treatment plan and timely targeted blood coagulation treatment. If a bleeding disorder is suspected, initial diagnostic testing consists of determining the aPTT, PT, platelet count and von Willebrand factor activity; global tests for disorders of haemostasis, such as the coagulation time and platelet function are not of any added value. It cannot be excluded that a patient in whom test results are normal may still have a platelet function disorder or a rare bleeding disorder. If there is a strong suspicion of a bleeding disorder this should always be discussed with a coagulation specialist.