Gynaecological management of women with inherited bleeding disorders. A UK Haemophilia Centres Doctors' Organisation Guideline.

Nicola Curry, Louise Bowles, T Justin Clark, Gillian Lowe, Jason Mainwaring, Sarah Mangles, Bethan Myers, Rezan Abdul Kadir

Journal: Haemophilia : the official journal of the World Federation of Hemophilia 2022;28(6):917-937

PMID: 35976756

Abstract

Women with inherited bleeding disorders (IBDs) may present to healthcare professionals in a variety of ways and commonly will be encountered by either haematology or gynaecology services. Heavy menstrual bleeding is very often the first manifestation of an IBD. There is a wide variation in severity of bleeding for women with IBD and diagnosis and subsequent management of their condition requires multidisciplinary specialised care which is tailored to the individual and includes excellent cross-specialty communication between gynaecology and haematology teams. This guideline is intended for both haematologists and gynaecologists who are involved in the diagnosis and management of women with bleeding disorders. It sets out recommendations about how to investigate heavy menstrual bleeding (HMB), the commonest presentation for women with IBD to hospital services, to guide physicians about how to diagnose an IBD and covers the management of women with known IBD and HMB. The second section sets out recommendations for patients known to have IBD and covers management of patients with IBD in the setting of gynaecological surgery and management for all other non-surgical gynaecological situations.

© 2022 John Wiley & Sons Ltd.

Address: Oxford Haemophilia and Thrombosis Centre, Oxford University Hospitals NHS Foundation Trust, and NIHR BRC Blood Theme, Oxford University, Oxford, UK.; The Royal London Hospital Haemophilia Comprehensive Care Centre, The Royal London Hospital, Whitechapel, London, UK.; Birmingham Women's NHS Foundation Trust, University of Birmingham, Birmingham, UK.; West Midlands Comprehensive Care Haemophilia Unit, University Hospitals Birmingham, Mindelsohn Way, Edgbaston, Birmingham, UK.; Bournemouth and Poole Haemophilia Centre, Royal Bournemouth Hospital, Castle Lane East, Bournemouth, Dorset, UK.; Haemophilia, Haemostasis and Thrombosis Centre, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.; Leicester Haemostasis and Thrombosis Centre, University Hospitals of Leicester, Leicester, UK.; Department of Obstetrics and Gynaecology, Katharine Dormandy Haemophilia and Thrombosis Unit, The Royal Free NHS Foundation Hospital and Institute for Women's Health, University College London, London, UK.
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