Women with inherited bleeding disorders and their offspring : the unresolved issues

The past few decades have seen major advances in management of gynaecological conditions and multidisciplinary obstetric care in women with inherited bleeding disorders (IBDs) and their offspring. However, there remain many unresolved issues within the field. A series of observational studies were conducted to address these issues with an overarching aim of improving patient care. A case-control study determined if there was an association between IBDs and endometriosis. Women with a surgically confirmed diagnosis of endometriosis (n = 84) and controls (n = 30) underwent investigations of haemostasis. Women with endometriosis had significantly more platelet aggregation defects to one and multiple agonists compared to controls (31% vs 4%, p = 0.005 and 15% vs 4%, p < 0.05, respectively). Reduced von willebrand factor (VWF) activity correlated with increased laparoscopic stage of endometriosis (r = -0.35, p = 0.01). A 10-year review and questionnaire study was carried out in carriers of haemophilia to determine their attitudes towards prenatal diagnosis. Sixty-one carriers of haemophilia had obstetric care in 73 pregnancies. Forty-one out of 61 women responded to the questionnaire. The uptake for invasive prenatal ... (continues)