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Identification and management of women with inherited bleeding disorders: a survey of obstetricians and gynaecologists in the United Kingdom
Author(s) -
CHI C.,
SHILTAGH N.,
KINGMAN C. E. C.,
ECONOMIDES D. L.,
LEE C. A.,
KADIR R. A.
Publication year - 2006
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/j.1365-2516.2006.01282.x
Subject(s) - medicine , von willebrand disease , haemophilia , population , obstetrics and gynaecology , presentation (obstetrics) , obstetrics , forceps , pediatrics , family medicine , gynecology , general surgery , pregnancy , surgery , von willebrand factor , platelet , environmental health , biology , immunology , genetics
Summary. A mail survey of members and fellows of Royal College of Obstetricians and Gynaecologists was carried out to determine current practices of obstetricians and gynaecologists in the United Kingdom in the management of women with inherited bleeding disorders. In total, 3929 questionnaires were sent, 707 returned and analysis was limited to 545 valid questionnaires. In the past 5 years, 91% have managed women with inherited bleeding disorders. The majority (83%) considered inherited bleeding disorders to be under diagnosed in obstetrics and gynaecology. More than 80% considered the prevalence of von Willebrand's disease (VWD) to be <0.2% in the general population and <1% in women with menorrhagia and no gynaecological pathology, although the reported prevalence is 1% and 5–25% respectively. Twelve percent of the respondents would arrange testing for VWD when reviewing an 18‐year‐old with menorrhagia and no pelvic pathology, while only 2% would do the same for a 35‐year‐old with the same presentation. Twenty‐one percent thought elective caesarean section is indicated in all fetuses known to be at risk of being affected by haemophilia. Eighty‐four percent considered vacuum extraction unsafe in these cases, but 76% would consider the use of low forceps. In conclusion, obstetricians and gynaecologists underestimate inherited bleeding disorders as an underlying cause for menorrhagia. Increased awareness and management guidelines are essential in minimizing haemorrhagic complications and improving quality of care of these women.