title: Gynaecological and obstetric bleeding in moderate and severe von Willebrand disease.
abstract: 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.
authors.affiliation: Erasmus University Medical Center, 3000 CA Rotterdam, Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: De Wee
authors.forename: H M
authors.initials: HM
authors.lastname: Knol
authors.forename: E P
authors.initials: EP
authors.lastname: Mauser-Bunschoten
authors.forename: J G
authors.initials: JG
authors.lastname: van der Bom
authors.forename: J C J
authors.initials: JC
authors.lastname: Eikenboom
authors.forename: K
authors.initials: K
authors.lastname: Fijnvandraat
authors.forename: A
authors.initials: A
authors.lastname: De Goede-Bolder
authors.forename: B
authors.initials: B
authors.lastname: Laros-van Gorkom
authors.forename: P F
authors.initials: PF
authors.lastname: Ypma
authors.forename: S
authors.initials: S
authors.lastname: Zweegman
authors.forename: K
authors.initials: K
authors.lastname: Meijer
authors.forename: F W G
authors.initials: FW
authors.lastname: Leebeek
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001780:Blood Coagulation Tests; D003430:Cross-Sectional Studies; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006306:Health Surveys; D006801:Humans; D007044:Hysterectomy; D050498:Live Birth; D008595:Menorrhagia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D009426:Netherlands; D006473:Postpartum Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult; D014842:von Willebrand Diseases / Q000097:blood / Q000150:complications* / Q000175:diagnosis*