Inherited bleeding disorders in obstetrics and gynaecology: a multidisciplinary approach

Around one in hundred women has an underlying bleeding disorder. The impact of having a bleeding disorder on the increased likelihood of developing heavy menstrual bleeding (HMB), postpartum haemorrhage (PPH) and the impact of bleeding disorders on sexual functioning in women are being recognised. Additional knowledge on screening women with a bleeding tendency for inherited bleeding disorders, exploring HMB in this population, revising peripartum guidelines for women diagnosed with inherited bleeding disorders and gaining insight into patient-guided counselling during the various reproductive phases is required to optimise care for these women. Close collaboration between a gynaecologist and a haematologist is essential to tailor these management strategies.
This thesis aimed to provide data on the occurrence and impact of women-specific bleeding in inherited bleeding disorders and to provide recommendations for care optimisation.

The two most common bleeding disorders, namely Von Willebrand disease (VWD) and haemophilia carriership (HC), are being investigated in Part I of this thesis. Part II of this thesis focused on a group of rare bleeding disorders: congenital platelet disorders (CPDs).

The findings of this thesis and suggestions for clinical practice for women with bleeding disorders during each phase of life and for future research are presented in the final chapter.