Gynaecological and obstetric bleeding in moderate and severe von Willebrand disease
Gynaecological and obstetric bleeding in moderate and severe von Willebrand disease
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DOI：
10.1160/th11-03-0180
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发表时间：
2011-11-01
影响因子：
6.7
通讯作者：
Leebeek, Frank W. G.
中科院分区：
文献类型：
--
作者：
de Wee, Eva M.;Knol, H. Marieke;Leebeek, Frank W. G.
一项全国范围的横断面研究开始评估在荷兰的一个队列中的妇女与中度和重度血管性血友病（VWD）的妇科和产科症状。共纳入423名年龄≥ 16岁的妇女。使用Tosetto出血评分（BS）测量出血严重程度。月经过多定义为出现>= 2个月经过多症状，报告率为81%。在所有VWD妇女中，78%的妇女接受了任何形式的月经过多治疗，20%的妇女主要因为严重的月经出血而接受了子宫切除术。超过一半的妇女报告失血量超过正常分娩的预期。在52%的报告流产，需要刮宫，因为出血。平均活产婴儿数为1.9，与荷兰总人口相当。总之，中度或重度VWD的妇女经常有月经过多需要治疗，20%的VWD妇女接受了子宫切除术。超过50%的妇女在分娩或流产后发生出血并发症。后代似乎不受影响的妇女与中度或重度VWD。
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.