Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA.
Haemophilia. 2010 Jul;16 Suppl 5:160-7. doi: 10.1111/j.1365-2516.2010.02315.x.
While women are rarely affected by haemophilia, they are equally as likely as men to have other bleeding disorders. Menorrhagia, or heavy menstrual bleeding, is the most common symptom that they experience. Not only is menorrhagia more prevalent among women with bleeding disorders, but bleeding disorders are more prevalent among women with menorrhagia. Although menorrhagia is the most common reproductive tract manifestation of a bleeding disorder, it is not the only manifestation. Women with bleeding disorders appear to be at an increased risk of developing haemorrhagic ovarian cysts and possibly endometriosis. Women suspected of having a bleeding disorder or being a carrier of haemophilia should be offered diagnostic testing before getting pregnant to allow for appropriate preconception counselling and pregnancy management. During pregnancy, women with bleeding disorders may be at an increased risk of bleeding complications. At the time of childbirth, women with bleeding disorders appear to be more likely to experience postpartum haemorrhage, particularly delayed or secondary postpartum haemorrhage. As women with bleeding disorders grow older, they may be more likely to manifest gynaecological conditions which present with bleeding. Women with bleeding disorders are more likely to undergo a hysterectomy and are more likely to have the operation at a younger age. While women with bleeding disorders are at risk for the same obstetrical and gynaecological problems that affect all women, women with bleeding disorders are disproportionately affected by conditions that manifest with bleeding. Optimal management involves the combined expertise of haemostasis experts and obstetrician-gynaecologists.
虽然女性很少受到血友病的影响，但她们与男性一样容易患有其他出血性疾病。月经过多，即月经大量出血，是她们最常见的症状。不仅月经过多在出血性疾病女性中更为普遍，而且出血性疾病在月经过多的女性中更为普遍。虽然月经过多是出血性疾病最常见的生殖系统表现，但它并不是唯一的表现。出血性疾病女性似乎更容易发生出血性卵巢囊肿，可能还有子宫内膜异位症。疑似患有出血性疾病或携带血友病的女性在怀孕前应接受诊断性检查，以便进行适当的孕前咨询和妊娠管理。在怀孕期间，出血性疾病女性可能会有更高的出血并发症风险。在分娩时，出血性疾病女性似乎更容易发生产后出血，尤其是延迟性或继发性产后出血。随着出血性疾病女性年龄的增长，她们可能更容易出现以出血为表现的妇科疾病。出血性疾病女性更有可能接受子宫切除术，并且更有可能在年轻时进行手术。虽然出血性疾病女性面临与所有女性相同的产科和妇科问题的风险，但她们受到以出血为表现的疾病的影响不成比例。最佳管理需要止血专家和妇产科医生的专业知识相结合。
