Skip to main content
Journal cover image

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

Publication ,  Journal Article
James, A; Matchar, DB; Myers, ER
Published in: 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 Willebrand disease," "diagnosis," and "screening," with a hand-search of bibliographies of identified articles, review of published abstracts, and discussion with experts. METHODS OF STUDY SELECTION: One hundred seven articles meeting search criteria were reviewed. Articles included in the study were those that provided primary data on the prevalence of von Willebrand disease in adult women with menorrhagia, quality of life, surgical complications, and the effectiveness of medical therapy in women with menorrhagia and von Willebrand disease and test characteristics of screening tests for von Willebrand disease. TABULATION, INTEGRATION, AND RESULTS: The reported prevalence of von Willebrand disease in women with menorrhagia ranged from 5-20% in 5 published studies. Comparison of results was limited by small sample sizes and large confidence intervals, as well as differences in the definitions of menorrhagia and von Willebrand disease used in the studies. Although menorrhagia in women with known von Willebrand disease has a substantial impact on quality of life, there are no data suggesting that this impact is substantially greater than that of menorrhagia in women without von Willebrand disease. Data on the risk of surgical bleeding in women with von Willebrand disease are limited, with only 3 studies with a total of 29 patients identified. Data on the effectiveness of specific therapies are also limited; only one controlled trial was identified. Of single tests for screening, one study of the ristocetin cofactor assay had a sensitivity of 79% and specificity of 90%. Studies of a test of platelet adhesion and aggregation resulted in pooled sensitivities of 83-94% and specificities of 80-88%; however, significant heterogeneity was present. CONCLUSION: There are inadequate data to justify routine testing for von Willebrand disease in adult women with menorrhagia outside of the research setting.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Obstet Gynecol

DOI

ISSN

0029-7844

Publication Date

August 2004

Volume

104

Issue

2

Start / End Page

381 / 388

Location

United States

Related Subject Headings

  • von Willebrand Diseases
  • Sensitivity and Specificity
  • Prevalence
  • Obstetrics & Reproductive Medicine
  • Menorrhagia
  • Mass Screening
  • Humans
  • Female
  • Diagnostic Tests, Routine
  • 3215 Reproductive medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
James, A., Matchar, D. B., & Myers, E. R. (2004). Testing for von Willebrand disease in women with menorrhagia: a systematic review. Obstet Gynecol, 104(2), 381–388. https://doi.org/10.1097/01.AOG.0000133487.55682.7b
James, Andra, David B. Matchar, and Evan R. Myers. “Testing for von Willebrand disease in women with menorrhagia: a systematic review.Obstet Gynecol 104, no. 2 (August 2004): 381–88. https://doi.org/10.1097/01.AOG.0000133487.55682.7b.
James A, Matchar DB, Myers ER. Testing for von Willebrand disease in women with menorrhagia: a systematic review. Obstet Gynecol. 2004 Aug;104(2):381–8.
James, Andra, et al. “Testing for von Willebrand disease in women with menorrhagia: a systematic review.Obstet Gynecol, vol. 104, no. 2, Aug. 2004, pp. 381–88. Pubmed, doi:10.1097/01.AOG.0000133487.55682.7b.
James A, Matchar DB, Myers ER. Testing for von Willebrand disease in women with menorrhagia: a systematic review. Obstet Gynecol. 2004 Aug;104(2):381–388.
Journal cover image

Published In

Obstet Gynecol

DOI

ISSN

0029-7844

Publication Date

August 2004

Volume

104

Issue

2

Start / End Page

381 / 388

Location

United States

Related Subject Headings

  • von Willebrand Diseases
  • Sensitivity and Specificity
  • Prevalence
  • Obstetrics & Reproductive Medicine
  • Menorrhagia
  • Mass Screening
  • Humans
  • Female
  • Diagnostic Tests, Routine
  • 3215 Reproductive medicine