Gynaecological management of women with inherited bleeding disorders. A UK Haemophilia Centres Doctors' Organisation Guideline
| dc.contributor.author | Myers, Bethan | |
| dc.date.accessioned | 2023-03-13T12:10:52Z | |
| dc.date.available | 2023-03-13T12:10:52Z | |
| dc.date.issued | 2022-08-17 | |
| dc.identifier.citation | Curry, N., Bowles, L., Clark, T. J., Lowe, G., Mainwaring, J., Mangles, S., Myers, B., & Kadir, R. A. (2022). Gynaecological management of women with inherited bleeding disorders. A UK Haemophilia Centres Doctors' Organisation Guideline. Haemophilia : the official journal of the World Federation of Hemophilia, 28(6), 917–937. https://doi.org/10.1111/hae.14643 | en_US |
| dc.identifier.other | 10.1111/hae.14643 | |
| dc.identifier.uri | http://hdl.handle.net/20.500.12904/16404 | |
| dc.description.abstract | 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. | |
| dc.description.uri | https://onlinelibrary.wiley.com/doi/10.1111/hae.14643 | en_US |
| dc.language.iso | en | en_US |
| dc.subject | Gynaecological management | en_US |
| dc.subject | Gynaecological surgery | en_US |
| dc.subject | Heavy menstrual bleeding | en_US |
| dc.subject | Inherited bleeding disorder and fertility | en_US |
| dc.subject | Inherited bleeding disorders | en_US |
| dc.subject | Ovulation-related bleeding | en_US |
| dc.title | Gynaecological management of women with inherited bleeding disorders. A UK Haemophilia Centres Doctors' Organisation Guideline | en_US |
| dc.type | Article | en_US |
| rioxxterms.funder | Default funder | en_US |
| rioxxterms.identifier.project | Default project | en_US |
| rioxxterms.version | NA | en_US |
| rioxxterms.versionofrecord | https://doi.org/10.1111/hae.14643 | en_US |
| rioxxterms.type | Journal Article/Review | en_US |
| refterms.panel | Unspecified | en_US |
| html.description.abstract | 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. | en_US |
| rioxxterms.funder.project | 94a427429a5bcfef7dd04c33360d80cd | en_US |
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Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial.Summary Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial.
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