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    Poster Networking

    Platelet Disorders, von Willebrand Disease and Thrombotic Microangiopathies

    Poster Networking Session

    PB0854 - Could gynecologists contribute to an increased diagnosis of von Willebrand disease among women with heavy menstrual bleeding?

    Monday, June 26, 2023
    18:30 – 19:30 ET
    Room: Exhibition

      Presenting Author(s)

    • Douglass Drelich, MD

      Associate Director, Global Medical Affairs - Hematology
      CSL Behring, King of Prussia, Pennsylvania, USA
      King of Prussia, Pennsylvania, United States

      • Co-Author(s)

    • JS

      Jolana Schmiedl

      Associate Director Haematology & Transplant Commercial Operations Intercontinental
      Swiss Tropical and Public Health Institute, Basel, Switzerland
      Basel, Basel-Stadt, Switzerland

      • Co-Author(s)

    • Giancarlo Castaman, MD

      Medical Director
      Center for Bleeding Disorders and Coagulation, Careggi University Hospital, Florence, Italy
      Florence, Toscana, Italy

      • Co-Author(s)

    • SB

      Soraya Benchikh El Fegoun

      Global Medical Director
      CSL Behring, Bern, Switzerland
      Bern, Bern, Switzerland

    Background: Von Willebrand disease (VWD) is the most prevalent inherited bleeding disorder, occurring in up to 1% of the general population. Approximately, 70–80% of women with VWD may experience heavy menstrual bleeding (HMB), however diagnosis based on this symptom is often delayed. Improved awareness between gynecology and hematology specialties could prompt earlier diagnoses for women with VWD and HMB.

    Aims: This study investigated how gynecologists refer women with HMB to hematologists.

    Methods: A two-part anonymized questionnaire was designed to evaluate the decision-making process for gynecologists referring women with HMB to hematologists. It also assessed the use of the Bleeding Assessment Tool (BAT) during consultations. Responders completed 26 questions regarding diagnosis, treatment, and burden of VWD in association with HMB. After 15 initial questions, responders were given information on the burden of HMB in correlation to VWD; responses were compared to evaluate changes in their decision-making process.

    Results: A total of 183 gynecologists from 22 countries completed the questionnaire; of which, 25% would refer women with HMB to a hematologist when hormonal therapy (HT) failed after 3–12 months, 62% after >1–5 years of failed HT, and 14% when bleeding complications occur during labor
    (Figure 1). Only 13% would consider a bleeding disorder as a cause for HMB during initial consultations; however, most responders reported that bleeding disorders, as cause of HMB, are underdiagnosed. When asked the reasons for the underdiagnosis of VWD, low-level awareness of the disease among first-contact physicians and gynecologists were reported (28% and 19%, respectively) and lack of availability of the BAT (8%). After learning about the association of HMB and VWD, 22% more responders would use the BAT to screen for VWD in each woman with HMB.

    Conclusion(s): Educating gynecologists about VWD could facilitate faster referrals of women with HMB to hematologists and increased diagnoses.