Reproductive Tract Bleeding in Adolescent and Young Adult Females with Inherited Bleeding Disorders: An Underappreciated Problem

Neeraja Swaminathan; Anjali Sharathkumar; Tazim Dowlut-McElroy

doi:10.1016/j.jpag.2022.07.006

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Reproductive Tract Bleeding in Adolescent and Young Adult Females with Inherited Bleeding Disorders: An Underappreciated Problem

Journal article

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Peer reviewed

Reproductive Tract Bleeding in Adolescent and Young Adult Females with Inherited Bleeding Disorders: An Underappreciated Problem

Neeraja Swaminathan, Anjali Sharathkumar and Tazim Dowlut-McElroy

Journal of pediatric & adolescent gynecology, Vol.35(6), pp.614-623

12/2022

DOI: 10.1016/j.jpag.2022.07.006

PMCID: PMC12017590

PMID: 35830928

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https://www.ncbi.nlm.nih.gov/pmc/articles/12017590View

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Abstract

Reproductive tract bleeding is an underappreciated health care problem among adolescent and young adult (AYA) females with inherited bleeding disorders (IBDs) comprising von Willebrand disease, platelet disorders, hemophilia carriership, and rare factor deficiencies. IBDs are prevalent in women of all ages and have been detected in about 50% of women with menorrhagia or heavy menstrual bleeding (HMB) and about 20% of women with postpartum hemorrhage (PPH). The clinical spectrum of gynecologic and obstetric bleeding in AYA with IBDs ranges from HMB, ovulation bleeding, and surgical bleeding to miscarriages and life-threatening PPH. Reproductive tract bleeding adversely affects the quality of life of this patient population, in addition to causing substantial morbidity and mortality. Early diagnosis of IBDs offers the opportunity for timely intervention with hormones, hemostatic agents, and prophylaxis with factor concentrates, thereby improving outcomes. This review summarizes the epidemiology, pathophysiology, clinical manifestations, diagnostic approach, management, and prophylaxis for reproductive tract bleeding in AYA with IBDs. This review provides a multidisciplinary approach to the problem, which is critical to improve the outcomes of this patient population.

CDC

VTE

AYA

PPH

PFA

PFD

FFP

PTT

RFD

UDC

Ang-1

IUD

PAI-1

DMPA

HMB

BMI

DIC

t-PA

PAR-2

VWD

COCs

VWF

DDAVP

VEGF

ATHN

IBDs

HESC

FUDC

TGA

MMP

PBAC

PCC

PCOS

HTC

TEG

ISTH-BAT

APH

TXA

CHC

Details

Title: Subtitle: Reproductive Tract Bleeding in Adolescent and Young Adult Females with Inherited Bleeding Disorders: An Underappreciated Problem
Creators: Neeraja Swaminathan - University of Michigan
Anjali Sharathkumar - University of Iowa Hospitals and Clinics
Tazim Dowlut-McElroy - Eunice Kennedy Shriver National Institute of Child Health and Human Development
Resource Type: Journal article
Publication Details: Journal of pediatric & adolescent gynecology, Vol.35(6), pp.614-623
DOI: 10.1016/j.jpag.2022.07.006
PMID: 35830928
PMCID: PMC12017590
NLM abbreviation: J Pediatr Adolesc Gynecol
ISSN: 1083-3188
eISSN: 1873-4332
Publisher: Elsevier Inc
Grant note: DOI: 10.13039/100013554, name: Foundation for Women and Girls with Blood Disorders
Language: English
Date published: 12/2022
Academic Unit: Stead Family Department of Pediatrics; Hematology/Oncology
Record Identifier: 9984354158802771

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