A MULTIDISCIPLINARY CLINIC FOR WOMEN WITH INHERITED BLEEDING DISORDERS

Abstract number: P-S-217

Lee¹ C.A., Chi² C., Shiltag³ N., Khan³ A., Pollard⁴ D., Griffioen⁵ A., Kadir² R.

¹¹University of London, Haemophilia Centre, Royal Free Hospital, London, UK, Cirencester ²²Obstetrics and Gynaecology, Royal Free Hospital ³³Haemophilia Centre, Royal Free Hospital ⁴⁴Haemophilia Centre, Royal Free Hospital ⁵⁵Haemophilia Centre, Royal Free Hospital, London, United Kingdom

How-to-cite Lee CA, Chi C, Shiltag N, Khan A, Pollard D, Griffioen A, Kadir R. A MULTIDISCIPLINARY CLINIC FOR WOMEN WITH INHERITED BLEEDING DISORDERS. J Thromb Haemost 2007; 5 Supplement 2: P-S-217

Abstract

Introduction: A 3-year review of a clinic providing a comprehensive service for women with inherited bleeding disorders was conducted. Referral sources were from within the hospital, general practitioners, tertiary referrals from haematologists and gynaecologists/obstetricians and self referral.

Methods: The specialists were a consultant haematologist and obstetrician/gynaecologist, haemophilia nurse specialist and a family therapist. The clinical records of attendees were reviewed. A questionnaire to target issues for the delivery of better care was sent to patients and the results analysed.

Results: 178 patients were seen during 3 years: 50(28%) carriers of haemophilia A or B; 44(25%) VWD; 39(22%) rare bleeding disorders, including 28(16%) factor XI deficiency; and 12(7%) inherited platelet disorders. 312 appointments were made: for menorrhagia 137(44%); management of pregnancy 112(36%), including 28(9%) prenatal counselling; prenatal counselling alone 13(4%); postmenopausal bleeding 11(4%); infertility 5(2%); contraception 2(1%); postoperative haemorrhage 2(1%); and miscellaneous conditions 30(10%). For menorrhagia the treatments prescribed/offered were: tranexamic acid 31/36, COCP 16/25, Mirena coil 12/33, DDAVP 3/8, progesterone 1/1, hysteroscopy 0/1, hysterectomy 2/4, and other treatments 5/16. 25 of 28 women opted for prenatal diagnosis;non-invasive tests performed were ultrasound 8 and free foetal DNA(ffDNA)16; invasive tests were CVS 5 (2 affected males). First line treatment for menorrhagia was effective for 30/61(50%). There were no bleeding complications in association with delivery. 68/111(61%) questionnaires were returned and 88% patients valued the multidisciplinary approach with the haematology and obstetrics/gynaecology professionals together with the patient at the consultation.

Conclusions: This multidisciplinary clinic model has delivered quality healthcare individualised for women with inherited bleeding disorders.

To cite this abstract use the following format:

Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number

Session Details

Date:	01/08/2007
Time:	00:00-00:00
Session name:	XXIst ISTH Congress
Subject:
Location:	Oxford, UK
Presentation type:
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