Oxford Haemophilia and Thrombosis Centre, Oxford University Hospitals NHS Foundation Trust, and NIHR BRC Blood Theme, Oxford University, Oxford, UK.
The Royal London Hospital Haemophilia Comprehensive Care Centre, The Royal London Hospital, Whitechapel, London, UK.
Haemophilia. 2022 Nov;28(6):917-937. doi: 10.1111/hae.14643. Epub 2022 Aug 17.
Women with inherited bleeding disorders (IBDs) may present to healthcare professionals in a variety of ways and commonly will be encountered by either haematology or gynaecology services. Heavy menstrual bleeding is very often the first manifestation of an IBD. There is a wide variation in severity of bleeding for women with IBD and diagnosis and subsequent management of their condition requires multidisciplinary specialised care which is tailored to the individual and includes excellent cross-specialty communication between gynaecology and haematology teams. This guideline is intended for both haematologists and gynaecologists who are involved in the diagnosis and management of women with bleeding disorders. It sets out recommendations about how to investigate heavy menstrual bleeding (HMB), the commonest presentation for women with IBD to hospital services, to guide physicians about how to diagnose an IBD and covers the management of women with known IBD and HMB. The second section sets out recommendations for patients known to have IBD and covers management of patients with IBD in the setting of gynaecological surgery and management for all other non-surgical gynaecological situations.
患有遗传性出血性疾病(IBD)的女性可能会以多种方式向医疗保健专业人员就诊,通常会遇到血液科或妇科服务。月经过多是 IBD 的最初表现之一。患有 IBD 的女性的出血严重程度差异很大,其诊断和后续管理需要多学科专业护理,根据个人情况量身定制,并包括妇科和血液科团队之间的出色交叉专业沟通。本指南旨在为参与诊断和管理出血性疾病女性的血液科医生和妇科医生提供帮助。它就如何调查月经过多(HMB)提出了建议,这是 IBD 女性最常见的就诊原因,旨在指导医生如何诊断 IBD,并涵盖了已知 IBD 和 HMB 女性的管理。第二部分为已知患有 IBD 的患者提出了建议,并涵盖了妇科手术环境中 IBD 患者的管理以及所有其他非手术妇科情况的管理。