Resource-Bleeding Disorders

This review will concentrate on the thrombin generation test, thromboelastography, the activated partial thromboplastin time waveform analysis and the CloFAL which measure the production of thrombin, as well as the kinetics of clot formation.

• Heavy menstrual bleeding is associated with both rare and common variants in genes related to anemias and bleeding disorders.

• These are the first exome-sequencing results of heavy menstrual bleeding patients as well as their comparison to control exomes.

Oral health is an important component of care at haemophilia treatment centres (HTCs). Correlations between oral health and inflammation suggest that proper oral health may improve joint health.

Dental habits and oral health in children and adolescents with bleeding disorders: A single-institution cross-sectional study. Haemophilia. 2021 Nov 20. doi: 10.1111/hae.14457. Epub ahead of print. PMID: 34800346.

Heavy menstrual bleeding (HMB) can be the first manifestation of an undiagnosed bleeding disorder (BD). Identifying a BD can be challenging in the adolescent age group. The utility of bleeding assessment tools (BAT) remains elusive in this population.

Heavy menstrual bleeding is common in adolescents. The frequency and predictors of bleeding disorders in adolescents, especially with anovulatory bleeding, are unknown. Adolescents referred for heavy menstrual bleeding underwent an evaluation of menstrual bleeding patterns, and bleeding disorders determined a priori. There is a high prevalence of bleeding disorders in adolescents with heavy periods, irrespective of the bleeding pattern. Among bleeding disorders, the prevalence of qualitative platelet dysfunction is lower than previously reported.

 Ayesha Zia, Shilpa Jain, Peter Kouides, Song Zhang, Ang Gao, Niavana Salas, May Lau, Ellen Wilson, Nicole DeSimone, Ravi Sarode. Bleeding disorders in adolescents with heavy menstrual bleeding in a multicenter prospective US cohort. Haematologica 2020;105(7):1969-1976; https://doi.org/10.3324/haematol.2019.225656.

Using the 2018 ASH guidelines for the management of VTE, Dr. Michael Streiff offers his insight on the most important takeaways for providers treating and managing VTE in patients.

Women or girls with haemophilia (WGH) represent a group of female symptomatic carriers who experience bleeding events more frequently than non‐carriers. Bleeding events include spontaneous/traumatic bleeds and prolonged bleeding related to surgery, menstruation, and pregnancy. Challenges for the treatment of WGH include lack of screening, diagnosis, and treatment guidelines.

When any fetal blood group factor inherited from the father is not possessed by the mother, antepartum or intrapartum fetal-maternal bleeding may stimulate an immune reaction in the mother. Maternal immune reactions also can occur from blood product transfusion. The formation of maternal antibodies, or "alloimmunization," may lead to various degrees of transplacental passage of these antibodies into the fetal circulation. Depending on the degree of antigenicity and the amount and type of antibodies involved, this transplacental passage may lead to hemolytic disease in the fetus and neonate. Undiagnosed and untreated, alloimmunization can lead to significant perinatal morbidity and mortality. Advances in Doppler ultrasonography have led to the development of noninvasive methods of management of alloimmunization in pregnant women. Together with more established protocols, Doppler ultrasound evaluation may allow for a more thorough and less invasive workup with fewer risks to the mother and fetus. Prevention of alloimmunization is addressed in another Practice Bulletin ().