TY - JOUR
T1 - Clinical management of woman with bleeding disorders
T2 - A survey among European haemophilia treatment centres
AU - van Galen, Karin P M
AU - Lavin, Michelle
AU - Skouw-Rasmussen, Naja
AU - Ivanova, Eva
AU - Mauser-Bunschoten, Eveline
AU - Punt, Marieke
AU - Romana, Gerychová
AU - Elfvinge, Petra
AU - D'Oiron, Roseline
AU - Abdul-Kadir, Rezan
N1 - Funding Information:
This survey has been made possible by support from the European Association for Haemophilia and Allied Disorders (EAHAD), especially with help from Livia Baogiu, Aislin Ryan and Mike Makris. We also thank the European Haemophilia Consortium for their support.
Funding Information:
This survey has been made possible by support from the European Association for Haemophilia and Allied Disorders (EAHAD), especially with help from Livia Baogiu, Aislin Ryan and Mike Makris. We also thank the European Haemophilia Consortium for their support.
Publisher Copyright:
© 2020 The Authors. Haemophilia published by John Wiley & Sons Ltd
PY - 2020/7
Y1 - 2020/7
N2 - Introduction: The impact of bleeding for women with bleeding disorders (WBD) is of increasing focus and importance. Despite this, optimal management strategies are unclear and knowledge gaps persist. Aim: To examine practices and define research priorities on diagnosis and management of WBD in Europe. Methods: An electronic survey on clinical management of WBD was sent to 136 European haemophilia treatment centres (HTCs), including open questions on knowledge gaps and research priorities. Results: Fifty-nine HTCs from 12 Western (WE) and 13 Central/Eastern European (CEE) countries completed the survey. Less than half runs a joint clinic (24 HTCs, 42%). Most centres without a joint clinic have a named obstetrician (81%) and/or gynaecologist (75%) available for collaboration. Overall 18/54 (33%) European HTCs do not offer preimplantation genetic diagnosis. Third trimester amniocentesis to guide obstetric management is available 28/54 HTCs (52%), less frequent in CEE compared to WE countries (5/17 vs 23/37, P =.03). 53% of HTCs (28/53) reported that only 0%-25% of WBD seek medical advice for heavy menstrual bleeding (HMB). An algorithm managing acute HMB in WBD is lacking in 22/53 (42%) HTCs. The main reported knowledge and research gaps are lack of awareness & education on WBD among patients and caregivers, optimal diagnostic strategies and effective multidisciplinary management of pregnancy & HMB. Conclusion: Joint clinics, prenatal diagnostics and algorithms for managing acute HMB are lacking in many European HTCs. HMB may be an underestimated issue. This survey highlights the need to prioritize improvement of knowledge and patient care for WBD across Europe.
AB - Introduction: The impact of bleeding for women with bleeding disorders (WBD) is of increasing focus and importance. Despite this, optimal management strategies are unclear and knowledge gaps persist. Aim: To examine practices and define research priorities on diagnosis and management of WBD in Europe. Methods: An electronic survey on clinical management of WBD was sent to 136 European haemophilia treatment centres (HTCs), including open questions on knowledge gaps and research priorities. Results: Fifty-nine HTCs from 12 Western (WE) and 13 Central/Eastern European (CEE) countries completed the survey. Less than half runs a joint clinic (24 HTCs, 42%). Most centres without a joint clinic have a named obstetrician (81%) and/or gynaecologist (75%) available for collaboration. Overall 18/54 (33%) European HTCs do not offer preimplantation genetic diagnosis. Third trimester amniocentesis to guide obstetric management is available 28/54 HTCs (52%), less frequent in CEE compared to WE countries (5/17 vs 23/37, P =.03). 53% of HTCs (28/53) reported that only 0%-25% of WBD seek medical advice for heavy menstrual bleeding (HMB). An algorithm managing acute HMB in WBD is lacking in 22/53 (42%) HTCs. The main reported knowledge and research gaps are lack of awareness & education on WBD among patients and caregivers, optimal diagnostic strategies and effective multidisciplinary management of pregnancy & HMB. Conclusion: Joint clinics, prenatal diagnostics and algorithms for managing acute HMB are lacking in many European HTCs. HMB may be an underestimated issue. This survey highlights the need to prioritize improvement of knowledge and patient care for WBD across Europe.
KW - bleeding disorder
KW - haemophilia
KW - heavy menstrual bleeding
KW - postpartum haemorrhage and reproduction
KW - survey
KW - von Willebrand disease
UR - http://www.scopus.com/inward/record.url?scp=85085498686&partnerID=8YFLogxK
U2 - 10.1111/hae.14043
DO - 10.1111/hae.14043
M3 - Article
C2 - 32459044
AN - SCOPUS:85085498686
SN - 1351-8216
VL - 26
SP - 657
EP - 662
JO - Haemophilia
JF - Haemophilia
IS - 4
ER -