Scholars@Duke
Andra Hohler James

Andra Hohler James

Professor Emeritus of Obstetrics and Gynecology
Obstetrics and Gynecology, Maternal Fetal Medicine
andra.james@duke.edu
Box 3967 Med Ctr, Durham, NC 27710
2608 Erwin Road, Suite 200, Durham, NC 27705

Scholarly Works - Journal articles

Drugs to Prevent and Treat Venous Thromboembolic Disease During Pregnancy.

Journal article Clin Perinatol · September 2026 The use of agents to prevent and treat thromboembolism in pregnancy continues to increase, likely a reflection of greater burden of comorbid conditions in pregnant people, increased awareness of venous thromboembolism prevention efforts, and enhanced acces ... Full text Link to item Cite

Infrastructure and workforce development processes inspired by Lived Experience Experts and grounded in health equity for the Bleeding Disorders Research Collaborative.

Journal article Expert Rev Hematol · July 2026 BACKGROUND: Accelerating research advancing health equity for the entire inheritable bleeding disorders community requires a new approach. It must be firmly rooted in health equity, diversity, and inclusion (HEDI) and center the knowledge of people living ... Full text Link to item Cite

Serum BAFF levels in pregnant patients with systemic lupus erythematosus.

Journal article Lupus · April 2026 Background/PurposeThe B cell Activating Factor (BAFF) signaling pathway influences rheumatic disease through its role in the selection, maturation, and survival of B cells. Increased BAFF also correlates with hypertension and preeclampsia in pregnant women ... Full text Link to item Cite

Postoperative venous thromboembolism following cesarean delivery: prevalence, pathophysiology, diagnosis, treatment, and prevention.

Journal article Am J Obstet Gynecol · January 2026 Venous thromboembolism contributes to approximately 10% of pregnancy-associated deaths in the United States, with the highest incidence rate in the immediate postpartum period. Cesarean deliveries are associated with 4-fold relative risk of venous thromboe ... Full text Link to item Cite

Agnostic identification of plasma biomarkers for postpartum hemorrhage risk.

Journal article Am J Obstet Gynecol · February 2025 BACKGROUND: Postpartum hemorrhage is difficult to predict, is associated with significant maternal morbidity, and is the leading cause of maternal mortality worldwide. The identification of maternal biomarkers that can predict increased postpartum hemorrha ... Full text Link to item Cite

Pregnancy loss in individuals with von Willebrand disease and unspecified mucocutaneous bleeding disorders: a multicenter cohort study.

Journal article J Thromb Haemost · February 2025 BACKGROUND: While bleeding around pregnancy is well described in von Willebrand disease (VWD), the risk of pregnancy loss is less certain. OBJECTIVES: We aimed to describe the frequency of pregnancy loss in females with VWD compared with those with a simil ... Full text Link to item Cite

Standard Compared With Extended Red Blood Cell Antigen Matching for Prevention of Subsequent Hemolytic Disease of the Fetus and Newborn: A Systematic Review.

Journal article Obstet Gynecol · October 1, 2024 OBJECTIVE: To systematically review and meta-analyze alloimmunization among recipients of red blood cells (RBCs) matched for ABO blood type and Rhesus D (ABO+D) antigen compared with those also matched for c, E, and Kell (cEK). DATA SOURCES: Four online da ... Full text Link to item Cite

Antithrombin testing and treatment in pregnancy: Their real-world relationship to clinical outcomes.

Journal article Thromb Res · September 2024 BACKGROUND: Antithrombin (AT) deficiency is a severe thrombophilia associated with increased rates of maternal morbidity, mortality, and greater healthcare resource utilization during pregnancy and postpartum. METHODS: Two large U.S. healthcare databases w ... Full text Link to item Cite

How I treat sickle cell disease in pregnancy.

Journal article Blood · February 29, 2024 Fifty years ago, people with sickle cell disease (SCD) were discouraged from becoming pregnant, but now, most should be supported if they choose to pursue a pregnancy. They and their providers, however, should be aware of the physiological changes of pregn ... Full text Link to item Cite

What do we know about why women bleed and what do we not know?

Journal article J Thromb Haemost · February 2024 Women or people with a uterus are vulnerable to both normal and abnormal bleeding. During the reproductive years, the uterus is prepared physiologically to accept an embryo and support its growth and development during pregnancy, or in the absence of impla ... Full text Link to item Cite

CT-001, a novel fast-clearing factor VIIa, enhanced the hemostatic activity in postpartum samples.

Journal article Blood Adv · January 23, 2024 The hemostatic system is upregulated to protect pregnant mothers from hemorrhage during childbirth. Studies of the details just before and after delivery, however, are lacking. Recombinant factor VIIa (rFVIIa) has recently been granted approval by the Euro ... Full text Link to item Cite

Management of pregnant women who have bleeding disorders.

Journal article Hematology Am Soc Hematol Educ Program · December 8, 2023 Bleeding disorders, including von Willebrand disease (VWD), hemophilia, other coagulation factor deficiencies, platelet disorders, defects of fibrinolysis, and connective tissue disorders, have both maternal and fetal implications. Successful management of ... Full text Link to item Cite

Projected impact of guidelines on incidence of venous thromboembolism after cesarean delivery in the United States.

Journal article J Thromb Haemost · December 2023 BACKGROUND: There is large variation in recommended for postcesarean delivery venous thromboembolism (VTE) prophylaxis among commonly used guidelines. OBJECTIVES: The aim of the study is to estimate implications of adoption of VTE prevention guidelines for ... Full text Link to item Cite

American Society of Hematology 2023 guidelines for management of venous thromboembolism: thrombophilia testing.

Journal article Blood Adv · November 28, 2023 Hereditary and acquired thrombophilia are risk factors for venous thromboembolism (VTE). Whether testing helps guide management decisions is controversial. These evidence-based guidelines from the American Society of Hematology (ASH) intend to support deci ... Full text Link to item Cite

High rates of venous thromboembolism among deliveries complicated by cancer.

Journal article J Thromb Haemost · October 2023 BACKGROUND: Venous thromboembolism (VTE) risk is increased independently by both cancer and pregnancy. OBJECTIVES: To estimate VTE risk in the postpartum period among patients delivering with a cancer diagnosis, stratified by cancer type and delivery route ... Full text Link to item Cite

Prospective Observational Study of N-terminal Pro-Brain Natriuretic Peptide Levels in Obese and Nonobese Women during Pregnancy.

Journal article Am J Perinatol · April 2023 OBJECTIVE: N-terminal pro-brain natriuretic peptide (NT-proBNP), a marker of ventricular dysfunction, varies by body mass index (BMI) outside of pregnancy. This study aimed to determine whether obesity affects NT-proBNP levels in pregnancy. STUDY DESIGN: T ... Full text Link to item Cite

Novel Antithrombotic Agents in Pregnancy Anticoagulants and Antiplatelet Agents.

Journal article Clin Obstet Gynecol · March 1, 2023 Increasing rates of thromboembolic complications have required increasing use of anticoagulant and antiplatelet agents during and after pregnancy. Furthermore, thromboembolism is both a cause and a complication of severe maternal morbidity requiring intens ... Full text Link to item Cite

Von Willebrand Disease, Hemophilia, and Other Inherited Bleeding Disorders in Pregnancy.

Journal article Obstet Gynecol · March 1, 2023 Inherited bleeding disorders, which comprise von Willebrand disease (VWD), hemophilia, other congenital clotting factor deficiencies, inherited platelet disorders, defects of fibrinolysis, and connective tissue disorders, have both maternal and fetal impli ... Full text Link to item Cite

Sickle cell disease and the incidence and etiology of preterm birth.

Journal article Am J Obstet Gynecol MFM · November 2022 BACKGROUND: Medically indicated delivery can be defined as delivery owing to intervention for maternal or fetal well-being-most commonly because of preeclampsia or nonreassuring fetal status. Among the general population of the United States, approximately ... Full text Link to item Cite

Transfusion Requirements with Hybrid Management of Placenta Accreta Spectrum Incorporating Targeted Embolization and a Selective Use of Delayed Hysterectomy.

Journal article Am J Perinatol · October 2022 OBJECTIVE: This study compares the number of units of red blood cells (RBCs) transfused in patients with placenta accreta spectrum (PAS) treated with or without a multidisciplinary algorithm that includes placental uterine arterial embolization (P-UAE) and ... Full text Link to item Cite

Disparities in obstetric hemorrhage outcomes.

Journal article Res Pract Thromb Haemost · January 2022 Both the maternal and fetal outcomes of pregnancy vary greatly according to a pregnant woman's community and her condition. The most devastating outcome is the death of a mother. In 2017, there were ≈295,000 maternal deaths globally with dramatic differenc ... Full text Link to item Cite

Iron Deficiency Anemia in Pregnancy.

Journal article Obstet Gynecol · October 1, 2021 Anemia is defined as a low red blood cell count, a low hematocrit, or a low hemoglobin concentration. In pregnancy, a hemoglobin concentration of less than 11.0 g/dL in the first trimester and less than 10.5 or 11.0 g/dL in the second or third trimester (d ... Full text Link to item Cite

Population pharmacokinetics and pharmacodynamics of Tranexamic acid in women undergoing caesarean delivery.

Journal article Br J Clin Pharmacol · September 2021 AIMS: The population pharmacokinetics (PK) and pharmacodynamics (PD) of tranexamic acid (TXA) have not been studied to prevent postpartum haemorrhage (PPH) in pregnant women. It is unclear which TXA dose assures sufficient PPH prevention. This study invest ... Full text Link to item Cite

Knowledge gaps in reproductive and sexual health in girls and women with sickle cell disease.

Journal article Br J Haematol · September 2021 There is an immediate need to address long-standing questions about the reproductive health of girls and women with sickle cell disease (SCD). There are many SCD-related reproductive risks and uncertainties across girls' and women's reproductive life span, ... Full text Link to item Cite

Optimal use of intravenous tranexamic acid for hemorrhage prevention in pregnant women.

Journal article Am J Obstet Gynecol · July 2021 BACKGROUND: Every 2 minutes, there is a pregnancy-related death worldwide, with one-third caused by severe postpartum hemorrhage. Although international trials demonstrated the efficacy of 1000 mg tranexamic acid in treating postpartum hemorrhage, to the b ... Full text Link to item Cite

Illustrated State-of-the-Art Capsules of the ISTH 2020 Congress.

Journal article Res Pract Thromb Haemost · July 2021 This year's Congress of the International Society of Thrombosis and Haemostasis (ISTH) was hosted virtually from Philadelphia July 17-21, 2021. The conference, now held annually, highlighted cutting-edge advances in basic, population and clinical sciences ... Full text Open Access Link to item Cite

The Society for Obstetric Anesthesia and Perinatology Interdisciplinary Consensus Statement on Neuraxial Procedures in Obstetric Patients With Thrombocytopenia.

Journal article Anesth Analg · June 1, 2021 Because up to 12% of obstetric patients meet criteria for the diagnosis of thrombocytopenia in pregnancy, it is not infrequent that the anesthesiologist must decide whether to proceed with a neuraxial procedure in an affected patient. Given the potential m ... Full text Link to item Cite

Venous thromboembolism incidence among patients recommended for pharmacologic thromboembolism prophylaxis after cesarean delivery in selected guidelines.

Journal article J Thromb Haemost · March 2021 BACKGROUND: Multiple guidelines regarding risk stratification for venous thromboembolism (VTE) incidence following cesarean delivery have been promulgated. OBJECTIVE: To estimate the percentage of cesarean delivery patients for which pharmacologic VTE woul ... Full text Link to item Cite

Women and girls with haemophilia: Lessons learned.

Journal article Haemophilia · February 2021 Severe and moderate factor VIII (FVIII) or IX (FIX) deficiencies in female carriers of haemophilia are rarely observed, but mild deficiency is quite frequent, although insufficiently recognized and registered. The confusion between the genetic diagnosis of ... Full text Link to item Cite

Application of a plasmin generation assay to define pharmacodynamic effects of tranexamic acid in women undergoing cesarean delivery.

Journal article J Thromb Haemost · January 2021 Essentials Tranexamic acid (TXA) is an antifibrinolytic drug used to reduce bleeding. Assaying plasmin generation (PG) in plasma detects clinically relevant TXA levels in vitro and ex vivo. 3.1-16.2 µg/mL TXA half-maximally inhibits PG in plasma from women ... Full text Link to item Cite

National trends in tranexamic acid use in the peripartum period, 2015-2019.

Journal article J Thromb Thrombolysis · October 2020 BACKGROUND: The purpose of this study was to measure trends in the use of tranexamic acid (TXA) during delivery in the United States and to evaluate demographic data and morbidity outcomes among these patients. METHODS: This retrospective cohort study incl ... Full text Link to item Cite

Developing a model for predicting venous thromboembolism in obese pregnant women in a national study.

Journal article Thromb Res · July 2020 INTRODUCTION: Venous thromboembolism (VTE) in pregnancy and postpartum is a leading cause of maternal morbidity and mortality in developed countries, where obesity is a known risk for this complication. Current guidelines vary in which patients qualify for ... Full text Link to item Cite

A national update on rates of postpartum haemorrhage and related interventions.

Journal article Blood Transfus · July 2020 BACKGROUND: Postpartum haemorrhage (PPH) is still a leading cause of maternal morbidity in the US. We aimed to reassess national trends in severe and non-severe PPH using recent data. MATERIAL AND METHODS: We performed a cross-sectional study using the 200 ... Full text Link to item Cite

Case-based discussion on the implications of exogenous estrogens in hemostasis and thrombosis: the obstetrician's view.

Journal article Hematology Am Soc Hematol Educ Program · December 6, 2019 This is the obstetrician's view on 3 different clinical scenarios involving bleeding and thrombotic disorders. In the first scenario, an 18 year old with a history of heavy menstrual bleeding since menarche presents with abdominal pain and ultrasound findi ... Full text Link to item Cite

Prevention of Postpartum Venous Thromboembolism.

Journal article Obstet Gynecol Surv · October 2019 IMPORTANCE: Postpartum venous thromboembolism (VTE) results in significant morbidity and mortality. The practicing obstetrician-gynecologist should have a plan for management and prevention. OBJECTIVE: The objective of this review is to familiarize obstetr ... Full text Link to item Cite

Sickle cell disease

Journal article Contemporary OB/GYN · July 2019 Cite

Contraceptive Methods and the Impact of Menstruation on Daily Functioning in Women with Sickle Cell Disease.

Journal article South Med J · March 2019 OBJECTIVES: Women with sickle cell disease (SCD) are living longer as a result of advances in the care of their underlying disease. With the population growing of women living with SCD, reproductive health issues in this population have become an emphasize ... Full text Link to item Cite

Multidisciplinary care results in similar maternal and perinatal mortality rates for women with and without SCD in a low-resource setting.

Journal article Am J Hematol · February 2019 In Africa, the maternal mortality rate in sickle cell disease (SCD) is ~10%. Our team previously demonstrated an 89% decrease in mortality rate in a before-and-after feasibility study among women with SCD living in low-resource setting in Ghana. In the sam ... Full text Link to item Cite

Acute Vaso-Occlusive Pain is Temporally Associated with the Onset of Menstruation in Women with Sickle Cell Disease.

Journal article J Womens Health (Larchmt) · February 2019 BACKGROUND: Acute vaso-occlusive pain episodes in sickle cell disease (SCD) are associated with increased rates of hospitalization and early mortality. Despite the observation that women have higher rates of acute vaso-occlusive pain episodes than men, sex ... Full text Link to item Cite

Correction: Predicting peripartum blood transfusion in women undergoing cesarean delivery: A risk prediction model.

Journal article PLoS One · 2019 [This corrects the article DOI: 10.1371/journal.pone.0208417.]. ... Full text Link to item Cite

Reproductive issues in sickle cell disease

Journal article Contemporary Ob Gyn · January 1, 2019 Cite

Blood Products in the Management of Abnormal Placentation.

Journal article Clin Obstet Gynecol · December 2018 A critical tool in the successful management of patients with abnormal placentation is an established massive transfusion protocol designed to rapidly deliver blood products in obstetrical and surgical hemorrhage. Spurred by trauma research and an understa ... Full text Link to item Cite

American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy.

Journal article Blood Adv · November 27, 2018 BACKGROUND: Venous thromboembolism (VTE) complicates ∼1.2 of every 1000 deliveries. Despite these low absolute risks, pregnancy-associated VTE is a leading cause of maternal morbidity and mortality. OBJECTIVE: These evidence-based guidelines of the America ... Full text Link to item Cite

Canadian Stroke Best Practice Consensus Statement: Acute Stroke Management during pregnancy.

Journal article Int J Stroke · October 2018 The Canadian Stroke Best Practice Consensus Statement Acute Stroke Management during Pregnancy is the second of a two-part series devoted to stroke in pregnancy. The first part focused on the unique aspects of secondary stroke prevention in a woman with a ... Full text Link to item Cite

Tranexamic Acid for Prevention and Treatment of Postpartum Hemorrhage: An Update on Management and Clinical Outcomes.

Journal article Obstet Gynecol Surv · October 2018 IMPORTANCE: Postpartum hemorrhage (PPH) remains a major cause of maternal mortality worldwide, occurring in both vaginal and cesarean deliveries. We have witnessed improvements in both prevention and treatment of PPH. Tranexamic acid (TXA) has been investi ... Full text Link to item Cite

Management of Menopausal Symptoms for Women Who Are at High Risk of Thrombosis.

Journal article Clin Obstet Gynecol · June 2018 For women at elevated risk of thrombosis, clinicians are challenged to relieve menopausal symptoms without increasing the risk of thrombosis. Oral menopausal hormone therapy increases the risk of venous thromboembolism by 2-fold to 3-fold. Observational st ... Full text Link to item Cite

Diagnosis and Management of VTE in Pregnancy.

Journal article Clin Obstet Gynecol · June 2018 Venous thromboembolism is a leading cause of maternal death. Because of the low absolute frequency of events, however, outcome-based clinical data are limited. Consequently, clinicians must additionally rely both on published guidelines and on extrapolatio ... Full text Link to item Cite

Prevention and Management of Thromboembolism in Pregnancy When Heparins Are Not an Option.

Journal article Clin Obstet Gynecol · June 2018 Heparins, unfractionated heparin, and low molecular weight heparin, are the preferred anticoagulants in pregnancy. There are circumstances, however, in which an alternative to heparin should be considered. These circumstances include, the presence of hepar ... Full text Link to item Cite

Canadian stroke best practice consensus statement: Secondary stroke prevention during pregnancy.

Journal article Int J Stroke · June 2018 The Canadian Stroke Best Practice Consensus Statement: Secondary Stroke Prevention during Pregnancy, is the first of a two-part series devoted to stroke in pregnancy. This document focuses on unique aspects of secondary stroke prevention in a woman with a ... Full text Link to item Cite

Contraceptive Management for Women Who Are at High Risk of Thrombosis.

Journal article Clin Obstet Gynecol · June 2018 Managing contraception for women at high risk for thrombosis poses unique challenges. Combined estrogen and progestin contraceptives increase the risk of both venous and arterial thrombosis. They are contraindicated in women with a history of thrombosis an ... Full text Link to item Cite

Managing Heavy Menstrual Bleeding in Women at Risk of Thrombosis.

Journal article Clin Obstet Gynecol · June 2018 Management of heavy menstrual bleeding (HMB) in a woman with a history of thrombosis, or who is otherwise at high risk of thrombosis, or who takes medications for anticoagulation can present a challenge to health care providers. The goal of treating HMB is ... Full text Link to item Cite

Perioperative Management of the Gynecologic Patient on Long-term Anticoagulation.

Journal article Clin Obstet Gynecol · June 2018 The perioperative management of patients taking antithrombotic or antiplatelet medications is based on an assessment of the individual patient's risk for thrombosis or bleeding, the specific medication involved, and the nature of the planned procedure. Thi ... Full text Link to item Cite

Prevention and Management of Stroke in Obstetrics and Gynecology.

Journal article Clin Obstet Gynecol · June 2018 Stroke risk is 3 times higher in pregnancy than in the general young adult population and carries high morbidity and mortality risks. The recognition of signs and symptoms of stroke and other serious cerebrovascular disorders in pregnant and postpartum pat ... Full text Link to item Cite

Efficacy, safety and pharmacokinetics of a new high-purity factor X concentrate in women and girls with hereditary factor X deficiency.

Journal article J Thromb Haemost · May 2018 UNLABELLED: Essentials Plasma-derived factor X concentrate (pdFX) is used to treat hereditary factor X deficiency. pdFX pharmacokinetics, safety and efficacy were assessed in factor X-deficient women/girls. Treatment success rate was 98%; only 6 adverse ev ... Full text Link to item Cite

Reasons for cesarean and medically indicated deliveries in pregnancies in women with systemic lupus erythematosus.

Journal article Lupus · March 2018 Objective To determine reasons for cesarean and medically indicated deliveries in a registry of pregnant women with SLE compared to RA. Methods Pregnant women with SLE or RA were prospectively followed, and pregnancy outcomes were collected, including whet ... Full text Link to item Cite

The Oxytocin Product Correlates with Total Oxytocin Received during Labor: A Research Methods Study.

Journal article Am J Perinatol · January 2018 Featured Publication OBJECTIVE: Total dose of oxytocin received during labor is an important variable in studies of human labor but is difficult to calculate. We sought to identify a surrogate measure for total dose of oxytocin received. STUDY DESIGN: For each subject receivin ... Full text Link to item Cite

Differences in bleeding phenotype and provider interventions in postmenarchal adolescents when compared to adult women with bleeding disorders and heavy menstrual bleeding.

Journal article Haemophilia · January 2018 INTRODUCTION: Due to lack of patient/health care provider awareness causing delayed diagnosis, the bleeding phenotype and provider interventions in adolescents with heavy menstrual bleeding (HMB) and bleeding disorders (BD) may be different when compared t ... Full text Link to item Cite

Variants in chondroitin sulfate metabolism genes in thrombotic storm.

Journal article Thromb Res · January 2018 INTRODUCTION: Thrombotic storm (TS) presents as a severe, acute thrombotic phenotype, characterized by multiple clotting events and frequently affecting younger adults. Understanding the extensive hypercoagulation of an extreme phenotype as TS will also pr ... Full text Link to item Cite

Predicting peripartum blood transfusion in women undergoing cesarean delivery: A risk prediction model.

Journal article PLoS One · 2018 OBJECTIVE: There has been an appreciable rise in postpartum hemorrhage requiring blood transfusions in the United States. Our objective is to better define patients at greatest risk for peripartum transfusion at the time of cesarean in order to identify ca ... Full text Link to item Cite

Fertility challenges for women with sickle cell disease.

Journal article Expert Rev Hematol · October 2017 Sickle cell disease (SCD) represents one of the most common monogenic blood disorders worldwide, with an incidence of over 300,000 newborns affected per year. Reproductive challenges for men and women with SCD have been previously reviewed; however, eviden ... Full text Link to item Cite

Management of hereditary antithrombin deficiency in pregnancy.

Journal article Thromb Res · September 2017 Antithrombin (AT) deficiency is a high-risk thrombophilia and a rare condition. Despite full anticoagulation during pregnancy and the postpartum period, women with AT deficiency may still be vulnerable to developing venous thromboembolism (VTE), including ... Full text Link to item Cite

Implementation of multidisciplinary care reduces maternal mortality in women with sickle cell disease living in low-resource setting.

Journal article Am J Hematol · September 2017 Sickle cell disease (SCD) is associated with adverse pregnancy outcome. In women with SCD living in low-resource settings, pregnancy is associated with significantly increased maternal and perinatal mortality rates. We tested the hypothesis that implementi ... Full text Link to item Cite

Feasibility of the Von Willebrand disease PREVENT trial.

Journal article Thromb Res · August 2017 BACKGROUND: Despite treatment, women with von Willebrand disease (VWD) have lower von Willebrand factor (VWF) levels and greater blood loss at delivery than controls. Current weight-based dosing does not account for the ~1.5-fold increase in blood volume i ... Full text Link to item Cite

Using antifibrinolytics in the peripartum period - concern for a hypercoagulable effect?

Journal article J Neonatal Perinatal Med · 2017 INTRODUCTION: Although antifibrinolytic agents are used to prevent and treat hemorrhage, there are concerns about a potential increased risk for peripartum venous thromboembolism. We sought to determine the impact of tranexamic acid and ɛ-aminocaproic acid ... Full text Open Access Link to item Cite

A global quantitative survey of hemostatic assessment in postpartum hemorrhage and experience with associated bleeding disorders.

Journal article Int J Womens Health · 2017 PURPOSE: Coagulopathy may be a serious complicating or contributing factor to postpartum hemorrhage (PPH), and should be promptly recognized to ensure proper bleeding management. This study aims to evaluate the approaches of obstetrician-gynecologists worl ... Full text Open Access Link to item Cite

Heavy menstrual bleeding: work-up and management.

Journal article Hematology Am Soc Hematol Educ Program · December 2, 2016 Heavy menstrual bleeding (HMB), which is the preferred term for menorrhagia, affects ∼90% of women with an underlying bleeding disorder and ∼70% of women on anticoagulation. HMB can be predicted on the basis of clots of ≥1 inch diameter, low ferritin, and ... Full text Link to item Cite

Progestin-only contraception and thromboembolism: A systematic review.

Journal article Contraception · December 2016 BACKGROUND: Women with medical conditions associated with increased risk for thrombosis generally should not use estrogen-containing contraceptives; however, less is known about progestin-only contraceptives (POCs) and thrombosis risk. OBJECTIVES: The obje ... Full text Link to item Cite

Management of Coagulopathy in Postpartum Hemorrhage.

Journal article Semin Thromb Hemost · October 2016 The purpose of this article is to review the use of blood products and hemostatic agents in the management of coagulopathy at the time of postpartum hemorrhage. Blood product administration strategies are broadly reviewed, including the role of the blood b ... Full text Link to item Cite

Contemporary issues in the management of von Willebrand disease.

Journal article Thromb Haemost · August 31, 2016 Von Willebrand disease (VWD) is the most common inherited bleeding disorder. Bleeding scores in VWD, focused in particular on mucosal bleeding, can be very useful in the diagnosis and validation of different types of treatment. The results of an extended p ... Full text Link to item Cite

Comparison of the trends in risk factors and management of severe postpartum hemorrhage: Years 2000–2004 versus 2005–2008

Journal article Journal of Reproductive Medicine · August 1, 2016 OBJECTIVE: To compare trends in the etiology and management of severe postpartum hemorrhage (PPH) during 2 time periods: 2000–2004 (Period 1) versus 2005–2008 (Period 2). STUDY DESIGN: Medical records with a diagnosis of PPH were identified by ICD-9 codes ... Cite

Comparison of the Trends in Risk Factors and Management of Severe Postpartum Hemorrhage Years 2000-2004 Versus 2005-2008.

Journal article J Reprod Med · August 2016 OBJECTIVE: To compare trends in the etiology and management of severe postpartum hemorrhage (PPH) during 2 time periods: 2000-2004 (Period 1) versus 2005-2008 (Period 2). STUDY DESIGN: Medical records with a diagnosis of PPH were identified by ICD-9 codes ... Link to item Cite

State of the art: von Willebrand disease.

Journal article Haemophilia · July 2016 The State of the Art in von Willebrand disease (VWD) has been impacted not only by discoveries in the field of haemostasis, but also by changes in practice in other fields. The development of bleeding assessment tools has led to the clarification of bleedi ... Full text Link to item Cite

Von Willebrand factor for menorrhagia: a survey and literature review.

Journal article Haemophilia · May 2016 BACKGROUND: von Willebrand disease (VWD) is the most common congenital bleeding disorder. In women, menorrhagia is the most common bleeding symptom, and is disabling with iron deficiency anaemia, high health cost and poor quality of life. Current hormonal ... Full text Link to item Cite

Recombinant Human Antithrombin in Pregnant Patients with Hereditary Antithrombin Deficiency: Integrated Analysis of Clinical Data.

Journal article Am J Perinatol · March 2016 OBJECTIVES: The purpose of this analysis was to evaluate the use of recombinant human antithrombin (rhAT) in preventing venous thromboembolism (VTE) in pregnant patients with hereditary AT deficiency (HATD). STUDY DESIGN: Data from two clinical trials were ... Full text Link to item Cite

Guidance for the treatment and prevention of obstetric-associated venous thromboembolism.

Journal article J Thromb Thrombolysis · January 2016 Venous thromboembolism (VTE), which may manifest as pulmonary embolism (PE) or deep vein thrombosis (DVT), is a serious and potentially fatal condition. Treatment and prevention of obstetric-related VTE is complicated by the need to consider fetal, as well ... Full text Open Access Link to item Cite

Thrombosis in pregnancy and maternal outcomes.

Journal article Birth Defects Res C Embryo Today · September 2015 Pregnancy increases the risk of thrombosis four- to five-fold. Seventy-five to eighty percent of pregnancy-related thrombotic events are venous and twenty to -twenty-five percent are arterial. The main reason for the increased risk is hypercoagulability. W ... Full text Link to item Cite

Medical and Obstetric Outcomes Among Pregnant Women With Congenital Heart Disease.

Journal article Obstet Gynecol · August 2015 OBJECTIVE: To estimate nationwide trends in the prevalence of maternal congenital heart disease (CHD) and determine whether women with CHD are more likely than women without maternal CHD to have medical and obstetric complications. METHODS: The 2000-2010 N ... Full text Link to item Cite

Management of reproductive hemorrhagic complications

Journal article JOURNAL OF THROMBOSIS AND HAEMOSTASIS · June 1, 2015 Link to item Cite

Temporal trends in maternal medical conditions and stillbirth.

Journal article Am J Obstet Gynecol · May 2015 OBJECTIVE: The objective of this study was to estimate the prevalence and temporal trends of medical conditions among women with stillbirth and to determine the effect of medical comorbidities on the trend of stillbirth. STUDY DESIGN: The Nationwide Inpati ... Full text Link to item Cite

Postpartum von Willebrand factor levels in women with and without von Willebrand disease and implications for prophylaxis.

Journal article Haemophilia · January 2015 The aim of this study was to elucidate the fall in von Willebrand factor (VWF) and factor VIII activity (FVIII) after childbirth in women with and without von Willebrand disease (VWD). VWF:RCo, VWF:Ag, and FVIII were obtained in the third trimester of preg ... Full text Link to item Cite

Origin, Incidence, and Management of Nongynecologic Pelvic Masses Seen on Cross-sectional Imaging.

Journal article J Reprod Med · 2015 OBJECTIVE: To characterize the origin of nongynecologic pelvic masses. STUDY DESIGN: Using a radiology database, women who underwent transvaginal ultrasound, CT scan, or MRI for the indication of pelvic mass or pelvic fullness were identified. Demographic ... Link to item Cite

Hemostatic assessment, treatment strategies, and hematology consultation in massive postpartum hemorrhage: results of a quantitative survey of obstetrician-gynecologists.

Journal article Int J Womens Health · 2015 OBJECTIVE: To assess potential diagnostic and practice barriers to successful management of massive postpartum hemorrhage (PPH), emphasizing recognition and management of contributing coagulation disorders. STUDY DESIGN: A quantitative survey was conducted ... Full text Open Access Link to item Cite

Low-molecular-weight heparin to prevent postpartum venous thromboembolism. A pilot randomised placebo-controlled trial.

Journal article Thromb Haemost · January 2015 The risk of venous thromboembolism (VTE) is elevated in the postpartum period. Low-molecular-weight heparin (LMWH) reduces the risk of VTE in many settings but is costly, inconvenient and increases bleeding. Randomised controlled trials (RCT) are required ... Full text Link to item Cite

Pre-existing Medical Conditions among Pregnant Women with Cardiomyopathy

Journal article International Journal of Cardiovascular Research · 2015 Full text Cite

The effects of intermittent pneumatic compression during cesarean delivery on fibrinolysis.

Journal article Am J Perinatol · October 2014 OBJECTIVE: Pregnancy is associated with increased risk for thromboembolic events. Intermittent pneumatic compression (IPC) devices are the method of thromboprophylaxis in a nonpregnant population. The aim of this study was to examine the effects of IPC on ... Full text Link to item Cite

Factors associated with the change in prevalence of cardiomyopathy at delivery in the period 2000-2009: a population-based prevalence study.

Journal article BJOG · October 2014 OBJECTIVE: Cardiomyopathy (CM) at delivery is increasing in prevalance. The objective of this study was to determine which medical conditions are attributable to this increasing prevalance. DESIGN: Population prevalence study from 2000 to 2009. SETTING: Th ... Full text Link to item Cite

Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members.

Journal article JAMA · September 10, 2014 IMPORTANCE: Sickle cell disease (SCD) is a life-threatening genetic disorder affecting nearly 100,000 individuals in the United States and is associated with many acute and chronic complications requiring immediate medical attention. Two disease-modifying ... Full text Link to item Cite

Characterization of antithrombin levels in pregnancy.

Journal article Thromb Res · September 2014 OBJECTIVE: To characterize antithrombin (AT) levels in normal pregnancy. METHODS: We performed secondary analyses with data from 3 studies. Using a single measurement from each subject in the first analysis (cross-sectional), we correlated AT levels with g ... Full text Link to item Cite

Evaluation and management of postpartum hemorrhage: consensus from an international expert panel.

Journal article Transfusion · July 2014 BACKGROUND: Postpartum hemorrhage (PPH) remains one of the leading causes of maternal morbidity and mortality worldwide, although the lack of a precise definition precludes accurate data of the absolute prevalence of PPH. STUDY DESIGN AND METHODS: An inter ... Full text Link to item Cite

Paratubal/Paraovarian Masses: A Study of Surgical and Non-Surgical Outcomes.

Journal article Medical Journal of Obstetrics And Gynecology · January 5, 2014 Cite

Differences in thrombotic risk factors in black and white women with adverse pregnancy outcome.

Journal article Thromb Res · January 2014 INTRODUCTION: Black women have an increased risk of adverse pregnancy outcomes and the characteristics of thrombotic risk factors in this population are unknown. The objective of this study was to examine the racial differences in thrombotic risk factors a ... Full text Link to item Cite

Medical and obstetric complications among pregnant women aged 45 and older.

Journal article PLoS One · 2014 OBJECTIVE: The number of women aged 45 and older who become pregnant is increasing. The objective of this study was to estimate the risk of medical and obstetric complications among women aged 45 and older. METHODS: The Nationwide Inpatient Sample was used ... Full text Open Access Link to item Cite

Whole-exome sequencing identifies novel risk variants for thrombotic storm

Journal article JOURNAL OF THROMBOSIS AND HAEMOSTASIS · December 1, 2013 Link to item Cite

Menorrhagia in patients with type I glycogen storage disease.

Journal article Obstet Gynecol · December 2013 OBJECTIVE: To evaluate menorrhagia in a cohort of women with glycogen storage disease type I because it appears to be an under-recognized problem in females of reproductive age. METHODS: A retrospective chart review was performed on 13 menstruating patient ... Full text Link to item Cite

Predictors of preterm birth in patients with mild systemic lupus erythematosus.

Journal article Ann Rheum Dis · September 1, 2013 OBJECTIVE: While increased disease activity is the best predictor of preterm birth in women with systemic lupus erythematosus (SLE), even women with low disease activity are at increased risk of this complication. Biomarkers that would identify at-risk pre ... Full text Link to item Cite

Use of a thrombopoietin mimetic for chronic immune thrombocytopenic purpura in pregnancy.

Journal article Obstet Gynecol · August 2013 BACKGROUND: Romiplostim, a thrombopoietin mimetic, is a novel therapeutic option for patients with chronic immune thrombocytopenic purpura. We report on the effects of romiplostim use throughout pregnancy. CASE: A 28-year-old primigravid woman with chronic ... Full text Link to item Cite

Differentially expressed microRNAs and affected biological pathways revealed by modulated modularity clustering (MMC) analysis of human preeclamptic and IUGR placentas.

Journal article Placenta · July 2013 INTRODUCTION: This study focuses on the implementation of modulated modularity clustering (MMC) a new cluster algorithm for the identification of molecular signatures of preeclampsia and intrauterine growth restriction (IUGR), and the identification of aff ... Full text Link to item Cite

Postpartum wound and bleeding complications in women who received peripartum anticoagulation.

Journal article Thromb Res · July 2013 INTRODUCTION: The objective of this study was to compare wound and bleeding complications between women who received anticoagulation after cesarean delivery due to history of prior venous thromboembolic disease, arterial disease, or being a thrombophilia c ... Full text Link to item Cite

How I treat thrombocytopenia in pregnancy.

Journal article Blood · January 3, 2013 A mild thrombocytopenia is relatively frequent during pregnancy and has generally no consequences for either the mother or the fetus. Although representing no threat in the majority of patients, thrombocytopenia may result from a range of pathologic condit ... Full text Link to item Cite

Prevention and treatment of venous thromboembolism in pregnancy in patients with hereditary antithrombin deficiency.

Journal article Int J Womens Health · 2013 OBJECTIVE: The aims of the study reported here were to provide data from six pregnant subjects who were enrolled in a clinical trial of antithrombin (AT) concentrate, discuss other published case series and case reports, and provide general guidance for th ... Full text Link to item Cite

Clinical causes and treatment of the thrombotic storm.

Journal article Expert Rev Hematol · December 2012 Thrombotic storm represents an extreme prothrombotic phenotype, characterized by multiple thrombotic events affecting diverse vascular beds occurring over a brief period of time. Thrombotic events involve venous and arterial circulation, including unusual ... Full text Link to item Cite

Lochia patterns among normal women: a systematic review.

Journal article J Womens Health (Larchmt) · December 2012 BACKGROUND: We conducted a systematic review of the literature to determine the amount and duration of blood loss 24 hours to 12 weeks after delivery. METHODS: We searched MEDLINE, CINAHL, and PubMed for studies between the years 1950 and 2011 that prospec ... Full text Link to item Cite

Clinical causes and treatment of the thrombotic storm.

Journal article Expert review of hematology · December 1, 2012 Thrombotic storm represents an extreme prothrombotic phenotype, characterized by multiple thrombotic events affecting diverse vascular beds occurring over a brief period of time. Thrombotic events involve venous and arterial circulation, including unusual ... Cite

An Altered Treatment Plan Based on Direct to Consumer (DTC) Genetic Testing: Personalized Medicine from the Patient/Pin-cushion Perspective.

Journal article J Pers Med · October 30, 2012 Direct to consumer (DTC) genomic services facilitate the personalized and participatory aspects of "P4" medicine, but raise questions regarding use of genomic data in providing predictive and preventive healthcare. We illustrate the issues involved by desc ... Full text Link to item Cite

Bleeding disorders: Impact on reproduction

Journal article Contemporary Ob Gyn · October 26, 2012 Knowledge of reproductive physiology and hematology is required to manage bleeding disorders such as von Willebrand disease and immune thrombocytopenia and mitigate inherent risks of excess bleeding or thrombosis throughout a woman's reproductive life. © 2 ... Cite

Reproduction and hemostasis and coagulation disorders

Journal article Giornale Italiano Di Ostetricia E Ginecologia · September 1, 2012 Cite

Prevention and treatment of venous thromboembolism in pregnancy.

Journal article Clin Obstet Gynecol · September 2012 During pregnancy, women have a 4- to 5-fold increased risk of thromboembolism. Candidates for anticoagulation in pregnancy include women with current thrombosis, a history of thrombosis, risk factors for postpartum thrombosis, and some women with thromboph ... Full text Link to item Cite

Prevention of venous thromboembolism in pregnancy: a review of guidelines, 2000-2011.

Journal article J Womens Health (Larchmt) · June 2012 INTRODUCTION: Pregnant women are four to five times more likely than nonpregnant women to develop venous thromboembolism (VTE). The aim of this review is to provide an overview of guidelines in the literature on VTE risk assessment, screening for thromboph ... Full text Link to item Cite

Postpartum hemorrhage: when uterotonics and sutures fail.

Journal article Am J Hematol · May 2012 Systemic bleeding at the time of postpartum hemorrhage (PPH) is usually the result of coagulopathy that has developed acutely as a result of massive hemorrhage after uterotonics and sutures have failed. Occasionally, the patient has a preexisting coagulopa ... Full text Link to item Cite

Guidance on the emergent reversal of oral thrombin and factor Xa inhibitors.

Journal article Am J Hematol · May 2012 The new oral anticoagulants dabigatran, rivaroxaban and apixaban have advantages over warfarin which include no need for laboratory monitoring, less drug-drug interactions and less food-drug interactions. However, there is no established antidote for patie ... Full text Link to item Cite

Management of gynecologic surgery in the patient with factor XI deficiency: a review of the literature.

Journal article Obstet Gynecol Surv · May 2012 UNLABELLED: Factor XI deficiency is a rare bleeding disorder that is more commonly found in Ashkenazi Jews. Bleeding manifestations of this disorder are varied and poorly correlate with factor XI levels. Spontaneous bleeding is uncommon, whereas delayed po ... Full text Link to item Cite

The effects of magnesium sulfate on maternal and fetal platelet aggregation.

Journal article J Matern Fetal Neonatal Med · May 2012 OBJECTIVE: To evaluate platelet function in mothers and fetuses/neonates exposed to magnesium sulfate intrapartum. METHODS: This was a prospective cohort study of mothers and fetuses/neonates exposed to magnesium sulfate intrapartum compared to mothers and ... Full text Link to item Cite

Factor X deficiency and pregnancy: preconception counselling and therapeutic options.

Journal article Haemophilia · May 2012 Women with factor X deficiency (FXD) who want to become pregnant face uncertain risks to themselves and to an unborn infant from haemorrhagic complications during pregnancy and at parturition. Women with FXD may also experience difficulty achieving pregnan ... Full text Link to item Cite

Consumption of Antithrombin at Delivery

Journal article AMERICAN JOURNAL OF HEMATOLOGY · May 1, 2012 Link to item Cite

Lack of genomic imprinting of DNA primase, polypeptide 2 (PRIM2) in human term placenta and white blood cells.

Journal article Epigenetics · May 2012 PRIM2, encoding a subunit of primase involved in DNA replication and transcription, is expressed in the placenta and is crucial for mammalian development and growth. Its role in placental function is not well understood. Recently, PRIM2 was reported as imp ... Full text Link to item Cite

Antithrombin Levels Are Significantly Lower During Pregnancy

Journal article AMERICAN JOURNAL OF HEMATOLOGY · May 1, 2012 Link to item Cite

Near-miss maternal mortality: cardiac dysfunction as the principal cause of obstetric intensive care unit admissions.

Journal article Obstet Gynecol · February 2012 OBJECTIVE: Evaluation of "near-miss" maternal mortality is a robust surveillance method to assess the quality of obstetric care and determinants of poor maternal outcome. To evaluate near-miss maternal mortality, we examined patient characteristics and mat ... Full text Link to item Cite

American Thoracic Society documents: an official American Thoracic Society/Society of Thoracic Radiology Clinical Practice Guideline--Evaluation of Suspected Pulmonary Embolism in Pregnancy.

Journal article Radiology · February 2012 BACKGROUND: Pulmonary embolism (PE) is a leading cause of maternal mortality in the developed world. Along with appropriate prophylaxis and therapy, prevention of death from PE in pregnancy requires a high index of clinical suspicion followed by a timely a ... Full text Link to item Cite

Cancer in pregnancy: cross-sectional oncologic imaging utilization at a tertiary care center with an algorithmic approach to imaging.

Journal article Clin Imaging · 2012 PURPOSE: To review utilization of imaging in pregnant patients with malignancies and define an imaging algorithm in this patient population. METHODS: Pregnant patients with concurrent diagnoses of malignancy from January 2002 to January 2011 were identifie ... Full text Link to item Cite

Body mass index and severe postpartum hemorrhage.

Journal article Gynecol Obstet Invest · 2012 BACKGROUND/AIMS: The purpose of this study was to determine the relationship between maternal characteristics and severe postpartum hemorrhage (PPH). METHODS: Medical records of women who delivered at Duke University Hospital between 2001 and 2004 with an ... Full text Link to item Cite

An official American Thoracic Society/Society of Thoracic Radiology clinical practice guideline: evaluation of suspected pulmonary embolism in pregnancy.

Journal article Am J Respir Crit Care Med · November 15, 2011 BACKGROUND: Pulmonary embolism (PE) is a leading cause of maternal mortality in the developed world. Along with appropriate prophylaxis and therapy, prevention of death from PE in pregnancy requires a high index of clinical suspicion followed by a timely a ... Full text Link to item Cite

Evaluation and management of acute menorrhagia in women with and without underlying bleeding disorders: consensus from an international expert panel.

Journal article Eur J Obstet Gynecol Reprod Biol · October 2011 Acute menorrhagia is a common gynecological disorder. Prevalence is high among women with inherited bleeding disorders and recent guidance for optimal management is lacking. Following a comprehensive review of the literature, an international expert panel ... Full text Link to item Cite

Practice bulletin no. 123: thromboembolism in pregnancy.

Journal article Obstet Gynecol · September 2011 Pregnant women have a fourfold to fivefold increased risk of thromboembolism compared with nonpregnant women (1, 2). Approximately 80% of thromboembolic events in pregnancy are venous (3), with a prevalence of 0.5–2.0 per 1,000 pregnant women (4–9). Venous ... Full text Link to item Cite

Maternal valvular heart disease in pregnancy.

Journal article Obstet Gynecol Surv · September 2011 UNLABELLED: Valvular heart disease is common in pregnancy. Maternal physiology changes significantly during gestation with substantial increases in cardiac output and blood volume; this can cause unmasking or worsening of cardiac disease. Acquired valvular ... Full text Link to item Cite

Obstetric hemorrhage.

Journal article J Thromb Haemost · August 2011 An obstetric hemorrhage may occur before or after delivery, but more than 80% of cases occur postpartum. Worldwide, a massive obstetric hemorrhage, resulting from the failure of normal obstetrical, surgical and/or systemic hemostasis, is responsible for 25 ... Full text Link to item Cite

Pregnancy outcomes associated with viral hepatitis.

Journal article J Viral Hepat · July 2011 The aim of this study was to examine the contribution of hepatitis B virus (HBV) and hepatitis C virus (HCV) to pregnancy-related complications including gestational diabetes mellitus (GDM), preterm birth (PTB), intrauterine growth restriction (IUGR), pre- ... Full text Link to item Cite

Surveillance of female patients with inherited bleeding disorders in United States Haemophilia Treatment Centres.

Journal article Haemophilia · July 2011 Inherited bleeding disorders are especially problematic for affected girls and women due to the monthly occurrence of menstrual periods and the effects on reproductive health. Although heavy menstrual bleeding (HMB) is the most common manifestation, female ... Full text Link to item Cite

Thrombotic storm revisited: preliminary diagnostic criteria suggested by the thrombotic storm study group.

Journal article Am J Med · April 2011 Physicians periodically encounter patients with an extraordinarily accelerated course of hypercoagulability who develop thromboses in multiple organ systems over days to weeks. Such patients may harbor underlying hypercoagulable clinical conditions, but th ... Full text Link to item Cite

Fibrinogen Appears To Be Consumed at Delivery

Journal article REPRODUCTIVE SCIENCES · March 1, 2011 Link to item Cite

Transcriptional profiling of human placentas from pregnancies complicated by preeclampsia reveals disregulation of sialic acid acetylesterase and immune signalling pathways.

Journal article Placenta · February 2011 The placenta plays an important role as a regulator of fetal nutrition and growth throughout development and placental factors contribute to gestational abnormalities such as preeclampsia. This study describes the genome-wide gene expression profiles of a ... Full text Link to item Cite

Oxytocin exposure during labor among women with postpartum hemorrhage secondary to uterine atony.

Journal article Am J Obstet Gynecol · January 2011 OBJECTIVE: We sought to determine if women with severe postpartum hemorrhage (PPH) secondary to uterine atony received greater amounts of oxytocin during labor compared to women without PPH. STUDY DESIGN: Subjects with severe PPH secondary to uterine atony ... Full text Link to item Cite

Obstetric management of adolescents with bleeding disorders.

Journal article J Pediatr Adolesc Gynecol · December 2010 Adolescents with bleeding disorders who become pregnant must contend with the dual challenges of their bleeding disorder and their pregnancy. Adolescents are more likely to terminate a pregnancy than adult women, and when they do carry a pregnancy, they ar ... Full text Link to item Cite

Rheumatologic Disorders in Pregnancy

Journal article · July 9, 2010 Full text Cite

Women and bleeding disorders.

Journal article Haemophilia · July 2010 While women are rarely affected by haemophilia, they are equally as likely as men to have other bleeding disorders. Menorrhagia, or heavy menstrual bleeding, is the most common symptom that they experience. Not only is menorrhagia more prevalent among wome ... Full text Link to item Cite

The optimal mode of delivery for the haemophilia carrier expecting an affected infant is caesarean delivery.

Journal article Haemophilia · May 2010 While a majority of affected infants of haemophilia carriers who deliver vaginally do not suffer a head bleed, the outcome of labour cannot be predicted. A planned vaginal delivery puts a woman at risk of an abnormal labour and operative vaginal delivery, ... Full text Link to item Cite

Liver disease in pregnancy.

Journal article Lancet · February 13, 2010 Severe liver disease in pregnancy is rare. Pregnancy-related liver disease is the most frequent cause of liver dysfunction in pregnancy and provides a real threat to fetal and maternal survival. A rapid diagnosis differentiating between liver disease relat ... Full text Link to item Cite

Pregnancy and thrombotic risk.

Journal article Crit Care Med · February 2010 Pregnancy increases the risk of thrombosis three-fold to four-fold. The main reason for the increased risk is hypercoagulability, which has likely evolved to protect women against the bleeding challenges associated with miscarriage and childbirth. The hype ... Full text Link to item Cite

Adolescent menorrhagia due to platelet function disorder.

Journal article J Pak Med Assoc · February 2010 The prevalence of menorrhagia in adolescent populations with bleeding disorders varies between 14% to 48%. The common conditions associated with menorrhagia include von Willebrand disease (VWD), platelet function disorders and coagulation factor deficienci ... Link to item Cite

Blood component therapy in postpartum hemorrhage.

Journal article Transfusion · November 2009 BACKGROUND: The purpose of this study was to examine blood component therapy in the treatment of postpartum hemorrhage. STUDY DESIGN AND METHODS: Records were reviewed for subjects who delivered during the 5-year period between January 1, 2000, and Decembe ... Full text Link to item Cite

Von Willebrand disease: key points from the 2008 National Heart, Lung, and Blood Institute guidelines.

Journal article Obstet Gynecol · September 2009 UNLABELLED: Von Willebrand disease (VWD) is the most common inherited bleeding disorder and may affect as many as one in 100 women. The condition results from a deficiency, dysfunction, or absence of von Willebrand factor (VWF). In women, the most common s ... Full text Link to item Cite

Complications of hysterectomy in women with von Willebrand disease.

Journal article 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 compl ... Full text Link to item Cite

Von Willebrand disease and other bleeding disorders in women: consensus on diagnosis and management from an international expert panel.

Journal article Am J Obstet Gynecol · July 2009 Reproductive tract bleeding in women is a naturally occurring event during menstruation and childbirth. In women with menorrhagia, however, congenital bleeding disorders historically have been underdiagnosed. This consensus is intended to allow physicians ... Full text Link to item Cite

Clinical and laboratory diagnosis of von Willebrand disease: a synopsis of the 2008 NHLBI/NIH guidelines.

Journal article Am J Hematol · June 2009 Von Willebrand factor (VWF) mediates blood platelet adhesion and accumulation at sites of blood vessel injury, and also carries coagulation factor VIII (FVIII) that is important for generating procoagulant activity. Von Willebrand disease (VWD), the most c ... Full text Link to item Cite

Consequences of smoking during pregnancy on maternal health.

Journal article J Womens Health (Larchmt) · June 2009 OBJECTIVE: To estimate the incidence of maternal cardiovascular and pulmonary events and the prevalence of other comorbid conditions among pregnant smokers. METHODS: We queried the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization ... Full text Link to item Cite

Migraines during pregnancy linked to stroke and vascular diseases: US population based case-control study.

Journal article BMJ · March 10, 2009 OBJECTIVE: To examine the association between migraine and cardiovascular diseases during pregnancy. Design US population based case-control study. SETTING: Nationwide inpatient sample, from the Healthcare Cost and Utilization Project of the Agency for Hea ... Full text Link to item Cite

Bleeding disorders in adolescents.

Journal article Obstet Gynecol Clin North Am · March 2009 Adolescents who have bleeding disorders are more likely to experience abnormal reproductive tract bleeding, particularly menorrhagia or heavy menstrual bleeding. Even though most abnormal reproductive tract bleeding in adolescents is not attributable to a ... Full text Link to item Cite

Venous thromboembolism in pregnancy.

Journal article Arterioscler Thromb Vasc Biol · March 2009 The purpose of this review is to summarize the epidemiology of venous thromboembolism (VTE) in pregnancy and describe strategies used to prevent and treat it. The main reason for the increased risk of VTE in pregnancy is hypercoagulability. The hypercoagul ... Full text Link to item Cite

von Willebrand factor content in Alphanate® (Laurence J. Logan) - Reply

Journal article Haemophilia · 2009 Featured Publication Full text Cite

Pregnancy-associated thrombosis.

Journal article Hematology Am Soc Hematol Educ Program · 2009 The main reason for the increased risk of thromboembolism in pregnancy is hypercoagulability, which has likely evolved to protect women from the bleeding challenges of miscarriage and childbirth. Women are at a 4- to 5-fold increased risk of thromboembolis ... Full text Link to item Cite

The clinical content of preconception care: women with chronic medical conditions.

Journal article Am J Obstet Gynecol · December 2008 This article reviews the medical conditions that are associated with adverse pregnancy outcomes for women and their offspring. We also present the degree to which specific preconception interventions and treatments can impact the effects of the condition o ... Full text Link to item Cite

Thromboembolism in pregnancy: recurrence risks, prevention and management.

Journal article Curr Opin Obstet Gynecol · December 2008 PURPOSE OF REVIEW: The purpose of this review is to summarize the epidemiology of thromboembolism in pregnancy and describe strategies to prevent and treat it. RECENT FINDINGS: The main reason for the increased risk of thrombosis in pregnancy is hypercoagu ... Full text Link to item Cite

142: Pregnancy outcomes associated with infectious hepatitis

Journal article American Journal of Obstetrics and Gynecology · December 2008 Full text Cite

An assessment of medical resource utilization and hospitalization cost associated with a diagnosis of anemia in women with obstetrical bleeding in the United States.

Journal article J Womens Health (Larchmt) · October 2008 OBJECTIVE: Anemia during pregnancy has been associated with adverse maternal and fetal outcomes. Although women with obstetrical bleeding are at increased risk for developing anemia, little is known about the prevalence and burden associated with anemia in ... Full text Link to item Cite

A national study of the complications of lupus in pregnancy.

Journal article Am J Obstet Gynecol · August 2008 OBJECTIVE: This study was undertaken to determine the risk of rare complications during pregnancy for women with systemic lupus erythematosus. STUDY DESIGN: By using the Nationwide Inpatient Sample from 2000-2003, we compared maternal and pregnancy complic ... Full text Link to item Cite

Morbidity associated with sickle cell disease in pregnancy.

Journal article Am J Obstet Gynecol · August 2008 OBJECTIVE: The purpose of this study was to identify morbidity that is associated with sickle cell disease (SCD) in pregnancy. STUDY DESIGN: The Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project of the Agency for Healthcare Resea ... Full text Link to item Cite

von Willebrand disease (VWD): evidence-based diagnosis and management guidelines, the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel report (USA).

Journal article Haemophilia · March 2008 von Willebrand disease (VWD) is a commonly encountered inherited bleeding disorder affecting both males and females, causing mucous membrane and skin bleeding symptoms, and bleeding with surgical or other haemostatic challenges. VWD may be disproportionate ... Full text Link to item Cite

Preterm premature rupture of membrane management--inpatient versus outpatient: a retrospective review.

Journal article Am J Perinatol · January 2008 The purpose of this study was to evaluate the outcome of patients with preterm premature rupture of membranes (PPROM) managed as inpatients who would have been candidates for outpatient management by prior published criteria. A retrospective review of medi ... Full text Link to item Cite

Aspirin and reproductive outcomes.

Journal article Obstet Gynecol Surv · January 2008 In the late 1980s and early 1990s, researchers hypothesized that aspirin could be used to prevent or delay the onset of preeclampsia. This hypothesis was tested in numerous trials which showed limited, but positive results. Subsequently, aspirin has been u ... Full text Link to item Cite

Guidelines for using VTE prophylaxis in pregnant women

Journal article Journal of Respiratory Diseases · December 1, 2007 Cite

Prevention and management of venous thromboembolism in pregnancy.

Journal article Am J Med · October 2007 Normal pregnancy is accompanied by an increase in clotting factors. The resulting hypercoagulable state has likely evolved to protect women from hemorrhage at the time of miscarriage and childbirth. During pregnancy, women are 4 times more likely to suffer ... Full text Link to item Cite

The management of Cesarean delivery in a parturient with paroxysmal nocturnal hemoglobinuria complicated by severe preeclampsia.

Journal article Can J Anaesth · August 2007 PURPOSE: To describe the anesthetic and peripartum management of a parturient with paroxysmal nocturnal hemoglobinuria complicated by severe preeclampsia, review the pathophysiology of this condition, rationale for thromboembolic prophylaxis, and its impli ... Full text Link to item Cite

Severe factor V deficiency presenting with intracranial haemorrhage during gestation.

Journal article Haemophilia · July 2007 We present a case of intracranial haemorrhage detected by ultrasound at 36 weeks gestation in a foetus who was ultimately diagnosed with severe factor V deficiency. An abnormality of the foetal heart rate, auscultated at a routine antenatal visit, prompted ... Full text Link to item Cite

Thromboembolism in pregnancy: recurrence and its prevention.

Journal article Semin Perinatol · June 2007 Fifteen to 25% of thromboembolic events in pregnancy are recurrent events. Women with a history of thrombosis have a three- to fourfold increased risk of recurrence when they are pregnant compared with when they are not. The risks are even higher postpartu ... Full text Link to item Cite

Bleeding events and other complications during pregnancy and childbirth in women with von Willebrand disease.

Journal article J Thromb Haemost · June 2007 BACKGROUND: Case reports and case series suggest that women with von Willebrand disease (VWD) are at an increased risk of bleeding complications during pregnancy and delivery. OBJECTIVES: To estimate the incidence of bleeding events and other complications ... Full text Link to item Cite

The U.S. Thrombosis and Hemostasis Centers pilot sites program.

Journal article J Thromb Thrombolysis · February 2007 Venous thromboembolism (VTE) is a common disorder associated with significant morbidity and mortality. Despite important advances in understanding the etiology of VTE, delivery of care to patients with thrombosis and thrombophilia is frequently incomplete ... Full text Link to item Cite

The cardiovascular complications of pregnancy.

Journal article Prog Cardiovasc Dis · 2007 Full text Link to item Cite

Bone density changes in women who receive thromboprophylaxis in pregnancy.

Journal article Am J Obstet Gynecol · October 2006 OBJECTIVE: The purpose of this study was to compare unfractionated heparin therapy to the low molecular weight heparin, enoxaparin sodium, and their effects on bone mineral density over the course of pregnancy. STUDY DESIGN: Pregnant patients whose conditi ... Full text Link to item Cite

Advancing the study of stroke in women: summary and recommendations for future research from an NINDS-Sponsored Multidisciplinary Working Group.

Journal article Stroke · September 2006 BACKGROUND AND PURPOSE: Women have poorer outcomes from stroke than men. Women also have risk factors that are unique, including pregnancy and hormone therapy. Hormone therapy for postmenopausal replacement increased the risk of ischemic stroke according t ... Full text Link to item Cite

Low-molecular-weight heparin for thromboprophylaxis in pregnant women with mechanical heart valves.

Journal article J Matern Fetal Neonatal Med · September 2006 BACKGROUND: Pregnancy in a woman with a mechanical heart valve is a life-threatening situation. Due to the inability of unfractionated heparin to prevent valvular thromboses, warfarin or other vitamin K antagonists have been the preferred anticoagulants fo ... Full text Link to item Cite

Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality.

Journal article Am J Obstet Gynecol · May 2006 OBJECTIVE: The purpose of this study was to estimate the incidence, risk factors, and mortality from pregnancy-related venous thromboembolism. STUDY DESIGN: The Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project of the Agency for ... Full text Link to item Cite

Unresolved issues in diagnosis and management of inherited bleeding disorders in the perinatal period: a White Paper of the Perinatal Task Force of the Medical and Scientific Advisory Council of the National Hemophilia Foundation, USA.

Journal article Haemophilia · May 2006 Haemophilia and inherited bleeding disorders in newborns and their carrier mothers pose unique challenges. The pattern of bleeding and the causes and risk factors for bleeding are decidedly different than an older child or an adult with haemophilia/inherit ... Full text Link to item Cite

Acute myocardial infarction in pregnancy: a United States population-based study.

Journal article Circulation · March 28, 2006 BACKGROUND: The purpose of this study was to determine the incidence, mortality, and risk factors for pregnancy-related acute myocardial infarction in the United States. METHODS AND RESULTS: The Nationwide Inpatient Sample for the years 2000 to 2002 was qu ... Full text Link to item Cite

Thrombophilia in pregnancy: Maternal and fetal implications

Journal article Current Women S Health Reviews · February 1, 2006 Pregnancy is accompanied by altered levels of coagulation factors, which are likely responsible for an increased risk of thrombosis, including an increased risk of deep vein thrombosis, pulmonary embolism, stroke and myocardial infarction. Women with throm ... Full text Cite

Von Willebrand disease.

Journal article Obstet Gynecol Surv · February 2006 UNLABELLED: Von Willebrand disease (VWD), the most common inherited bleeding disorder, results from a deficiency of von Willebrand factor (VWF), a protein required for the normal adhesion of platelets to the site of injured endothelium and for preservation ... Full text Link to item Cite

Bleeding disorders in premenopausal women: (another) public health crisis for hematology?

Journal article Hematology Am Soc Hematol Educ Program · 2006 Premenopausal women with bleeding disorders represent a major public health problem. Estimates suggest up to 20% of women with menorrhagia have an underlying bleeding disorder (corresponding to a prevalence of 1.5-4 million American women). Von Willebrand ... Full text Link to item Cite

Anticoagulants in pregnancy.

Journal article Obstet Gynecol Surv · January 2006 UNLABELLED: Pregnancy is a hypercoagulable state that increases the risk of thromboembolic events. These risks may be further increased in the presence of an acquired or inherited thrombophilia. Thrombophilias have been associated with both maternal and fe ... Full text Link to item Cite

Circulating angiogenic factors and abnormal uterine artery Doppler velocimetry in the second trimester.

Journal article Hypertens Pregnancy · 2006 OBJECTIVE: Circulating angiogenic growth factors (such as vascular endothelial growth factor [VEGF] and placental growth factor [PlGF]) and their interaction may be associated with vascular remodeling of spiral arteries in normal pregnancy. Soluble Flt-1, ... Full text Link to item Cite

Incidence and risk factors for stroke in pregnancy and the puerperium

Journal article Obstetrical and Gynecological Survey · January 1, 2006 Full text Cite

Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study.

Journal article Ann Intern Med · November 15, 2005 BACKGROUND: The risk for venous thromboembolism during pregnancy or postpartum is uncertain. OBJECTIVES: To estimate the relative and absolute risk for deep venous thrombosis and pulmonary embolism during pregnancy and postpartum and to describe trends in ... Full text Link to item Cite

Incidence and risk factors for stroke in pregnancy and the puerperium.

Journal article Obstet Gynecol · September 2005 OBJECTIVE: To estimate the incidence, mortality, and risk factors for pregnancy-related stroke in the United States. METHODS: The Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality ... Full text Link to item Cite

Thrombosis during pregnancy and the postpartum period.

Journal article Am J Obstet Gynecol · July 2005 OBJECTIVE: To describe the circumstances surrounding deep vein thrombosis among pregnant or postpartum patients enrolled in a large multicenter registry. STUDY DESIGN: Consecutive patients with ultrasound-confirmed deep vein thrombosis were enrolled at 183 ... Full text Link to item Cite

More than menorrhagia: a review of the obstetric and gynaecological manifestations of bleeding disorders.

Journal article Haemophilia · July 2005 In women, menorrhagia may be the most common manifestation of a bleeding disorder, but it is not the only reproductive tract abnormality that women with bleeding disorders experience. Women with bleeding disorders appear to be at an increased risk of devel ... Full text Link to item Cite

Utility of fetal echocardiogram in high-risk patients.

Journal article Aust N Z J Obstet Gynaecol · April 2005 AIM: Patients at high risk of fetal congenital heart disease are commonly referred for second trimester fetal echocardiogram. The objective of this study was to evaluate the utility of routine fetal echocardiogram in high-risk patients after the evaluation ... Full text Link to item Cite

Thrombosis, thrombophilia, and thromboprophylaxis in pregnancy.

Journal article Clin Adv Hematol Oncol · March 2005 Normal pregnancy is accompanied by changes in coagulation that have likely evolved to protect women from the bleeding challenges of miscarriage and childbirth. Consequently, pregnant women are at an increased risk of thrombosis. The most important risk fac ... Link to item Cite

Prenatal screening for thrombophilia: the background and the approach.

Journal article Gynecol Obstet Invest · 2005 Coagulation is a normal response to blood vessel injury and involves the interaction of endothelium, platelets and clotting factors. Coagulation is altered by pregnancy and may be further altered by thrombophilia, an acquired or inherited predisposition to ... Full text Link to item Cite

Prenatal diagnosis of a trauma-related fetal epidural hematoma.

Journal article Obstet Gynecol · December 2004 BACKGROUND: Prenatal diagnosis of fetal intracranial hemorrhage has important etiologic, management, and prognostic implications. Ultrasonography and magnetic resonance imaging (MRI) have been used to identify and evaluate this condition. We present the fi ... Full text Link to item Cite

Use of a new platelet function analyzer to detect von Willebrand disease in women with menorrhagia.

Journal article Am J Obstet Gynecol · August 2004 OBJECTIVE: The purpose of this study was to assess the usefulness of a new platelet function analyzer in the detection of von Willebrand disease and platelet dysfunction in women with menorrhagia. STUDY DESIGN: Women with menorrhagia and control subjects w ... Full text Link to item Cite

Testing for von Willebrand disease in women with menorrhagia: a systematic review.

Journal article Obstet Gynecol · August 2004 OBJECTIVE: To review the evidence supporting screening of adult women with menorrhagia for von Willebrand disease. DATA SOURCES: MEDLINE search from January 1,1990, to December 31, 2003, for articles in English, using keywords "menorrhagia," "von Willebran ... Full text Link to item Cite

Pregnancy with prolonged fetal exposure to an angiotensin-converting enzyme inhibitor.

Journal article J Perinatol · 2002 Maternal exposure to angiotensin-converting enzyme (ACE) inhibitors has consistently been associated with significant fetal toxicity. We report the case of a 24-year-old woman, gravida 3, para 1-0-1-1 who presented at 24 2/7 weeks' gestation with initial a ... Full text Link to item Cite

Combined deficiency of factors II, VII, IX, and X (Borgschulte-Grigsby deficiency) in pregnancy.

Journal article Obstet Gynecol · May 2001 BACKGROUND: Combined deficiency of vitamin K-dependent coagulation factors (II, VII, IX, X) is an uncommon challenge for the expectant gravida. CASE: A 34-year-old primigravida had congenital combined deficiency of factors II, VII, IX, and X that were inco ... Full text Link to item Cite

Thrombophilic DNA Mutations As Independent Risk Factors for Stroke and Avascular Necrosis in Sickle Cell Anemia.

Journal article Hematology · 2001 Thrombosis may be important in the pathophysiology of certain complications of sickle cell anemia (SCA), including cerebrovascular accident (CVA, stroke) and avascular necrosis (AVN). No single laboratory or clinical parameter can accurately identify patie ... Full text Link to item Cite

Assessment of primary hemostasis by PFA-100 analysis in a tertiary care center.

Journal article Thromb Haemost · July 2000 We evaluated the utility of the PFA-100 platelet function analyzer in identifying disorders in platelet function and/or von Willebrand factor (vWF) in patients with various systemic disorders being followed at a tertiary care center. Closure times were det ... Link to item Cite

Management of Patients at Increased Risk for Thrombosis

Journal article Postgraduate Obstetrics & Gynecology · December 1998 Full text Cite

Clostridium difficile infection in obstetric and gynecologic patients.

Journal article South Med J · September 1997 We reviewed hospital records of women on the obstetrics and gynecologic services with a diagnosis of antibiotic-associated diarrhea, pseudomembranous colitis, or Clostridium difficile infection to better characterize the incidence and course of women with ... Full text Link to item Cite