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Severe postpartum haemorrhage as first presenting symptom of an inherited bleeding disorder
- Source :
- Haemophilia, 25(6), 1051-1058. Wiley-Blackwell Publishing Ltd
- Publication Year :
- 2019
-
Abstract
- Introduction: Postpartum haemorrhage (PPH) is the major cause of maternal death worldwide. Haemostatic abnormalities are independently associated with a signifi‐ cantly increased risk for severe PPH. In this study, the value of haemostatic evalua‐ tion in women with severe PPH was explored. Aim: To investigate the occurrence of previously unknown inherited bleeding disor‐ ders in women with severe PPH. Methods: Women with severe PPH (blood loss of ≥2000 mL) between 2011 and 2017, referred to the haematology outpatient clinic for haemostatic evaluation, were retrospectively included. A bleeding disorder was diagnosed based on (inter)national guidelines, or when having a clear bleeding phenotype, not fulfilling any diagnos‐ tic criteria or laboratory abnormalities, this being classified as Bleeding of Unknown Cause (BUC). Logistic regression was used to model the association between diagno‐ sis and obstetrical causes and risk factors for PPH. Results: In total, 85 women with PPH were included. In 23% (n = 16), a mild bleed‐ ing disorder was diagnosed, including low von Willebrand factor (Low VWF 8/16), platelet function disorders (PFD 5/16), BUC (2/16) and von Willebrand disease type 1 (1/16). No significant associations were found between obstetrical causes or risk factors for PPH and the presence of a bleeding disorder. Conclusion: In 23% of women with severe PPH, a mild bleeding disorder was di‐ agnosed, independent of obstetrical causes or risk factors for PPH. This implies that severe PPH can be the first clinical symptom of an inherited bleeding disor‐ der. Therefore, to optimize clinical management, haemostatic evaluation after severe PPH is recommended.
- Subjects :
- Adult
medicine.medical_specialty
Pediatrics
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Von Willebrand factor
Blood loss
Risk Factors
Internal medicine
medicine
Von Willebrand disease
Outpatient clinic
Humans
Genetics (clinical)
Retrospective Studies
Hematology
biology
business.industry
Postpartum Hemorrhage
General Medicine
Bleed
Blood Coagulation Disorders
medicine.disease
Postpartum haemorrhage
biology.protein
Maternal death
Female
business
030215 immunology
Subjects
Details
- ISSN :
- 13652516 and 13518216
- Volume :
- 25
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Haemophilia : the official journal of the World Federation of HemophiliaREFERENCES
- Accession number :
- edsair.doi.dedup.....a5b3c4691e0eafa0b7a0cb4213c10c6f