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Complications of hysterectomy in women with von Willebrand disease.

Publication ,  Journal Article
James, AH; Myers, ER; Cook, C; Pietrobon, R
Published in: Haemophilia
July 2009

Case reports and small case series suggest that women with von Willebrand disease (VWD) are at a very high risk of bleeding complications with hysterectomy. As the procedure may be beneficial to women who suffer from heavy menstrual bleeding and have completed childbearing, an understanding of the true risks involved is essential for appropriate decision making. To estimate the incidence of bleeding and other complications in women with VWD who undergo hysterectomy. The United States Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality for the years 1988-2004 was queried for all hysterectomies for non-malignant conditions. Data were analysed based on the NIS sampling design. Bivariate analyses were used to examine the differences between women with and without VWD. Multivariate analysis was used to adjust for potential confounders among women who underwent hysterectomy for heavy menstrual bleeding. 545 of the 1 358 133 hysterectomies were to women with VWD. Women with VWD were significantly more likely to experience intraoperative and postoperative bleeding (2.75% vs. 0.89%, P < 0.001) and require transfusion (7.34% vs. 2.13%, P < 0.001) than women without VWD. One woman with VWD died. While the risk of bleeding complications from hysterectomy in women with VWD is smaller than previously reported, women with VWD did experience significantly more bleeding complications than women without VWD. Nonetheless, for women who have completed childbearing, the risks of hysterectomy may be acceptable.

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Published In

Haemophilia

DOI

EISSN

1365-2516

Publication Date

July 2009

Volume

15

Issue

4

Start / End Page

926 / 931

Location

England

Related Subject Headings

  • von Willebrand Diseases
  • Treatment Outcome
  • Transfusion Reaction
  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Menorrhagia
  • Incidence
  • Hysterectomy
  • Humans
 

Citation

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James, A. H., Myers, E. R., Cook, C., & Pietrobon, R. (2009). Complications of hysterectomy in women with von Willebrand disease. Haemophilia, 15(4), 926–931. https://doi.org/10.1111/j.1365-2516.2009.02022.x
James, A. H., E. R. Myers, C. Cook, and R. Pietrobon. “Complications of hysterectomy in women with von Willebrand disease.Haemophilia 15, no. 4 (July 2009): 926–31. https://doi.org/10.1111/j.1365-2516.2009.02022.x.
James AH, Myers ER, Cook C, Pietrobon R. Complications of hysterectomy in women with von Willebrand disease. Haemophilia. 2009 Jul;15(4):926–31.
James, A. H., et al. “Complications of hysterectomy in women with von Willebrand disease.Haemophilia, vol. 15, no. 4, July 2009, pp. 926–31. Pubmed, doi:10.1111/j.1365-2516.2009.02022.x.
James AH, Myers ER, Cook C, Pietrobon R. Complications of hysterectomy in women with von Willebrand disease. Haemophilia. 2009 Jul;15(4):926–931.
Journal cover image

Published In

Haemophilia

DOI

EISSN

1365-2516

Publication Date

July 2009

Volume

15

Issue

4

Start / End Page

926 / 931

Location

England

Related Subject Headings

  • von Willebrand Diseases
  • Treatment Outcome
  • Transfusion Reaction
  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Menorrhagia
  • Incidence
  • Hysterectomy
  • Humans