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
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
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