Prophylactic and therapeutic strategies for intraoperative bleeding in women with von Willebrand disease and heavy menstrual bleeding: A systematic review

H P Eising*, M C Punt, J C Leemans, M Y Bongers

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

BACKGROUND: Optimal peri-operative management for women with Von Willebrand disease (VWD) and heavy menstrual bleeding (HMB) remains undetermined. AIM AND METHODS: To evaluate (pre)operative management in relation to (post)operative bleeding after endometrial ablation (EA) and hysterectomy in VWD women with HMB by performing a database search between 1994 and 2023. RESULTS: Eleven cohort studies and 1 case-report were included, of overall 'low' quality, describing 691 operative procedures. Prophylaxis (Desmopressin, clotting factor concentrates or tranexamic acid) to prevent bleeding was described in 100% (30/30) of EA procedures and in 4% (24/661) of hysterectomies. Bleeding complications despite prophylaxis were described in 13% (3/24) of hysterectomies vs 0% (0/30) in EA. CONCLUSION: VWD women often seem to experience bleeding complications during hysterectomy and all women with VWD received preprocedural hemostatic agents during EA, indicating potential under- and overdosing of current prophylactic strategies. Prospective studies are needed to determine the optimal (pre)operative strategy for gynecological surgical procedures in women with VWD.
Original languageEnglish
Article number101131
Number of pages7
JournalBlood Reviews
Volume62
DOIs
Publication statusPublished - Nov 2023

Keywords

  • Bleeding disorders
  • Endometrial ablation techniques
  • Heavy menstrual bleeding
  • International society on thrombosis and Haemostasis bleeding assessment tool
  • von Willebrand disease

Fingerprint

Dive into the research topics of 'Prophylactic and therapeutic strategies for intraoperative bleeding in women with von Willebrand disease and heavy menstrual bleeding: A systematic review'. Together they form a unique fingerprint.

Cite this