Clinical applications of fibrinolytic inhibition in gynaecology

Bonnar, J.; Guillebaud, John; Kasonde, J.M.; Sheppard, B. L.

doi:10.1136/jcp.33.suppl_14.55

Cited by 19 publications

(12 citation statements)

References 19 publications

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“…Tranexamic acid has been shown to reduce menstrual blood loss by reducing endometrial plasminogen activator activity and antigen. 8 However, high and frequent doses are necessary which may reduce patient compliance, although there is a report of the successful use of single high dose tranexamic acid in three patients with type 2 von Willebrand's disease. 14 Antifibrinolytics are safe and inexpensive and useful as a first line treatment.…”

Section: Discussionmentioning

confidence: 99%

The use of levonorgestrel‐releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders

Kingman

Kadir

Lee

et al. 2004

BJOG

174

112

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a Background The levonorgestrel-releasing intrauterine system (LNG-IUS) is used commonly by gynaecologists as a contraceptive and to treat menorrhagia. However, its efficacy has not been examined in women with inherited bleeding disorders. Design A prospective pilot study.Setting A teaching hospital in north London with a designated haemophilia centre.Population Female patients with a known inherited bleeding disorder.Methods Sixteen women with subjective and objective menorrhagia caused by inherited bleeding disorders (13 von Willebrand's Disease, two factor XI deficiency and one Hermansky -Pudlak syndrome), who had previously undergone unsuccessful medical treatment were followed up for nine months after LNG-IUS insertion. Bleeding was measured by pictorial chart and haemoglobin concentration. Results All women reported that their periods were improved, pictorial chart scores were lower and 56% became amenorrhoeic. None reported side effects. Conclusion The LNG-IUS is well tolerated and effective and improves quality of life.

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Section: Discussionmentioning

confidence: 99%

The use of levonorgestrel‐releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders

Kingman

Kadir

Lee

et al. 2004

BJOG

174

112

View full text Add to dashboard Cite

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“…Oral combined contraceptives are valuable and currently the most commonly used treatment for menorrhagia in these patients. Tranexamic acid is also known signi®cantly to reduce excessive menstrual blood loss associated with inherited bleeding disorders [7] by reducing both plasminogen activator activity and plasmin activity in menstrual¯uid [8]. Desmopressin (DDAVP) administered intranasally as a spray has been shown to increase plasma levels of FVIII and vWF in patients with mild haemophilia A or vWD type 1 [9,10] and has been shown to be effective in the management of menorrhagia [11] in these patients.…”

Section: Discussionmentioning

confidence: 99%

Quality of life during menstruation in patients with inherited bleeding disorders

Sabin²,

et al. 1998

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Menorrhagia is a common and major problem for patients with inherited bleeding disorders, especially vWD. Quality of life during menstruation was assessed in 99 patients with inherited bleeding disorders including vWD (n = 57), carriers of haemophilia A (n = 17), carriers of haemophilia B (n = 7) and FXI deficiency (n = 18), and comparison was performed with an age-matched control group (n = 69). A questionnaire was used that included four main sections: (i) general health, (ii) health and daily activities, (iii) dysmenorrhea and (iv) quality of life during the menstrual period. Although patients with inherited bleeding disorders felt that their health (in general) was very good, they had significantly poorer quality of life on all the scales used than controls. Thirty-nine per cent reported having cut down on the amount of time spent on work and other activities as a result of their menstruation; 47% felt that they accomplished less than they would like during this period, 38% felt that they were limited in the kind of work and other activities that they could do, and 40% found that it took extra effort to perform their work. Fifty-one per cent experienced moderate, severe or very severe dysmenorrhoea. Quality of life was statistically poorer in patients with vWD, menstrual scores > 100 according to the pictorial blood assessment chart (PBAC), those who had periods > or = 8 days and those who experienced flooding or passage of clots. In conclusion, menstruation has a negative effect on the quality of life in patients with inherited bleeding disorders especially in those with objectively confirmed menorrhagia.

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“…As a result, there is a theoretical rationale for the use of antifibrinolytic agents in the treatment of postpartum haemorrhage. [9][10][11] A major trial is in progress in different parts of world to establish the efficacy of the drug to arrest Post-Partum Hemorrhage (PPH). The CRASH-2 trial has evaluated that tranexamic acid significantly reduces mortality in trauma patients who are profusely bleeding.…”

Section: Introductionmentioning

confidence: 99%

Intravenous 1 gram tranexamic acid for prevention of blood loss and blood transfusion during caesarean section: a randomized case control study

Ramani

Nayak

2014

Int J Reprod Contracept Obstet Gynecol

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Clinical applications of fibrinolytic inhibition in gynaecology

Cited by 19 publications

References 19 publications

The use of levonorgestrel‐releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders

The use of levonorgestrel‐releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders

Quality of life during menstruation in patients with inherited bleeding disorders

Intravenous 1 gram tranexamic acid for prevention of blood loss and blood transfusion during caesarean section: a randomized case control study

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