High prevalence of postpartum hemorrhage in women with rare bleeding disorders in the Netherlands : retrospective data from the RBiN study
Copyright © 2022 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Women with rare bleeding disorders (RBDs), including coagulation factor deficiencies and fibrinolytic disorders, may have a higher risk of postpartum hemorrhage (PPH). Information on this patient category is lacking in the existing PPH guidelines because data on PPH in patients with RBDs are scarce.
OBJECTIVE: To describe the prevalence of PPH in women with an RBD and evaluate the use of peripartum hemostatic prophylaxis.
METHODS: In the Rare Bleeding Disorders in the Netherlands (RBiN) study, patients with RBDs (n = 263) were included from all 6 Dutch hemophilia treatment centers. Patient-reported information on delivery, peripartum hemostatic prophylaxis, and occurrence of PPH was collected retrospectively. If available, information about the precise volume of postpartum blood loss was extracted from electronic patient files. PPH was defined as blood loss ≥500 mL (World Health Organization guideline).
RESULTS: A total of 244 pregnancies, including 193 livebirths, were reported by 85 women. A considerable proportion of these women experienced PPH, ranging from 30% in factor V deficiency to 100% in hyperfibrinolysis. Overall, PPH was reported in 44% of deliveries performed with and 53% of deliveries performed without administration of peripartum hemostatic prophylaxis. Blood loss was significantly higher in deliveries without administration of hemostatic prophylaxis (median 1000 mL) compared to deliveries with administration of prophylaxis (median 400 mL) (p = 0.011). Patients with relatively mild deficiencies also frequently experienced PPH when peripartum hemostatic prophylaxis was omitted.
CONCLUSION: PPH is common in rare coagulation factor deficiencies, both severe and mild, and fibrinolytic disorders, especially when peripartum prophylactic hemostatic treatment was not administered. The use of prophylactic hemostatic treatment was associated with less postpartum blood loss.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
Journal of thrombosis and haemostasis : JTH - 21(2023), 3 vom: 01. März, Seite 499-512 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Maas, Dominique P M S M [VerfasserIn] |
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| Links: |
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| Themen: |
Blood Coagulation Factors |
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| Anmerkungen: |
Date Completed 03.03.2023 Date Revised 10.03.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jtha.2022.11.009 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM352067535 |
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| 100 | 1 | |a Maas, Dominique P M S M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a High prevalence of postpartum hemorrhage in women with rare bleeding disorders in the Netherlands |b retrospective data from the RBiN study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 03.03.2023 | ||
| 500 | |a Date Revised 10.03.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Women with rare bleeding disorders (RBDs), including coagulation factor deficiencies and fibrinolytic disorders, may have a higher risk of postpartum hemorrhage (PPH). Information on this patient category is lacking in the existing PPH guidelines because data on PPH in patients with RBDs are scarce | ||
| 520 | |a OBJECTIVE: To describe the prevalence of PPH in women with an RBD and evaluate the use of peripartum hemostatic prophylaxis | ||
| 520 | |a METHODS: In the Rare Bleeding Disorders in the Netherlands (RBiN) study, patients with RBDs (n = 263) were included from all 6 Dutch hemophilia treatment centers. Patient-reported information on delivery, peripartum hemostatic prophylaxis, and occurrence of PPH was collected retrospectively. If available, information about the precise volume of postpartum blood loss was extracted from electronic patient files. PPH was defined as blood loss ≥500 mL (World Health Organization guideline) | ||
| 520 | |a RESULTS: A total of 244 pregnancies, including 193 livebirths, were reported by 85 women. A considerable proportion of these women experienced PPH, ranging from 30% in factor V deficiency to 100% in hyperfibrinolysis. Overall, PPH was reported in 44% of deliveries performed with and 53% of deliveries performed without administration of peripartum hemostatic prophylaxis. Blood loss was significantly higher in deliveries without administration of hemostatic prophylaxis (median 1000 mL) compared to deliveries with administration of prophylaxis (median 400 mL) (p = 0.011). Patients with relatively mild deficiencies also frequently experienced PPH when peripartum hemostatic prophylaxis was omitted | ||
| 520 | |a CONCLUSION: PPH is common in rare coagulation factor deficiencies, both severe and mild, and fibrinolytic disorders, especially when peripartum prophylactic hemostatic treatment was not administered. The use of prophylactic hemostatic treatment was associated with less postpartum blood loss | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a blood coagulation disorders | |
| 650 | 4 | |a delivery, obstetric | |
| 650 | 4 | |a fibrinolysis | |
| 650 | 4 | |a postpartum hemorrhage | |
| 650 | 4 | |a pregnancy | |
| 650 | 7 | |a Hemostatics |2 NLM | |
| 650 | 7 | |a Blood Coagulation Factors |2 NLM | |
| 700 | 1 | |a Saes, Joline L |e verfasserin |4 aut | |
| 700 | 1 | |a Blijlevens, Nicole M A |e verfasserin |4 aut | |
| 700 | 1 | |a Cnossen, Marjon H |e verfasserin |4 aut | |
| 700 | 1 | |a den Exter, Paul L |e verfasserin |4 aut | |
| 700 | 1 | |a van der Heijden, Olivier W H |e verfasserin |4 aut | |
| 700 | 1 | |a Kruis, Ilmar C |e verfasserin |4 aut | |
| 700 | 1 | |a Meijer, Karina |e verfasserin |4 aut | |
| 700 | 1 | |a Peters, Marjolein |e verfasserin |4 aut | |
| 700 | 1 | |a Schutgens, Roger E G |e verfasserin |4 aut | |
| 700 | 1 | |a van Heerde, Waander L |e verfasserin |4 aut | |
| 700 | 1 | |a Nieuwenhuizen, Laurens |e verfasserin |4 aut | |
| 700 | 1 | |a Schols, Saskia E M |e verfasserin |4 aut | |
| 700 | 0 | |a RBiN study group |e verfasserin |4 aut | |
| 700 | 1 | |a Maas, D P M S M |e investigator |4 oth | |
| 700 | 1 | |a Saes, J L |e investigator |4 oth | |
| 700 | 1 | |a Meijer, K |e investigator |4 oth | |
| 700 | 1 | |a Cnossen, M H |e investigator |4 oth | |
| 700 | 1 | |a Schutgens, R E G |e investigator |4 oth | |
| 700 | 1 | |a Peters, M |e investigator |4 oth | |
| 700 | 1 | |a Nieuwenhuizen, L |e investigator |4 oth | |
| 700 | 1 | |a Exter, P L den |e investigator |4 oth | |
| 700 | 1 | |a Kruis, I C |e investigator |4 oth | |
| 700 | 1 | |a van Heerde, W L |e investigator |4 oth | |
| 700 | 1 | |a Schols, S E M |e investigator |4 oth | |
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