In this podcast, Dr Sarah O’Brien and Dr Homa Ahmadzia discuss gynaecological considerations in women and girls who have an underlying bleeding disorder. The experts discuss the two sides of the coin regarding women with bleeding disorders: women may have uterine bleeding due to their bleeding disorder, however there can also be gynaecological causes for the heavy bleeding. Dr O’Brien and Dr Ahmadzia also review the signs and symptoms of bleeding disorders, as well as gynaecological causes for uterine bleeding including endometriosis, adenomyosis fibroids, and uterine anomalies. They discuss treatment as well as specific situations such as gynaecological surgery, and the importance of collaboration with other specialists.

Dr Sarah O’Brien is a Paediatric Haematologist at Nationwide Children’s Hospital in Columbus, OH, USA and Dr Homa Ahmadzia is a Maternal and Foetal Medicine Physician at George Washington University, DC, USA

In this podcast, Obstetrician and Gynaecologist Prof. Rezan Abdul-Kadir and Advanced Nurse Practicioner Debra Pollard discuss the impact of bleeding disorders before, during and after pregnancy and delivery. Their share their views on what healthcare providers should take into consideration when a woman with a bleeding disorder wants to have children and becomes pregnant, including potential risks and expectations of the pregnancy. Support for women and babies is discussed, including the importance of multidisciplinary care. The experts also explore their experience during and after delivery, and what to be aware of in the post-partum period.

Prof Rezan Abdul-Kadir is an Obstetrician and Gynaecologist at the Royal Free Hospital in London and Debra Pollard is an Advanced Nurse Practicioner at the Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital in London, UK.

In this podcast, Prof. Cedric Hermans and Prof. Jerzy Windyga discuss their perspectives on the changing paradigms of haemophilia care. They share their past experience and their views on the current situation in Europe, based on results from a recent survey and published in Therapeutic Advances in Hematology. The aim of this survey was to determine whether the paradigms of haemophilia care in Europe have changed with the introduction of novel treatment options. In the podcast, the two experts not only discuss the past and present of haemophilia care, but also share their visions on the future.

Prof. Hermans is the Head of the Division of Haematology at the Cliniques Universitaires of Saint-Luc in Brussels, Belgium. Prof. Windyga is the Head of the Department of Haemostasis Disorders and Internal Medicine at the Institute of Haematology and Transfusion Medicine in Warsaw, Poland. Both experts are members of HEMOSTASIS CONNECT’s European Collaborative Haemophilia Network.

COR2ED Medical Education: Prof. Karin Fijnvandraat, Professor of Paediatric Haematology at the University of Amsterdam in the Netherlands and Dr. Maria Elisa Mancuso, Senior Consultant in Haematology at IRCCS Humanitas Research Hospital in Milan, Italy, have an interesting discussion about prophylaxis in children with haemophilia. Along with five other members of the European Collaborative Haemophilia Network, Prof. Fijnvandraat and Dr. Mancuso recently published a white paper on prophylaxis in children in an evolving treatment landscape, in the journal Haemophilia.

In this podcast episode the two experts discuss when they start prophylaxis in young children, how they choose between plasma-derived and recombinant products and how they select the right treatment regimen, as well as practical aspects of starting prophylaxis, including the importance of involving parents in the decision-making process. 

In this third episode of the podcast series Women and Girls Bleed Too, Advanced Nurse Practitioner Debra Pollard (Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital, London, UK) is joined by Haematologist Dr. Michelle Lavin (RCSI and National Coagulation Centre, St James’ Hospital, Dublin, Ireland). They talk about the impact a bleeding disorder can have on the lives on women and girls and how these patients can and should be supported in first- and second-line care.

When thinking about management, many healthcare providers will first consider medical treatment. Dr. Lavin gives a brief overview of the first-line treatment options for women and girls with bleeding symptoms. However, the speakers stress that the management of these patients goes beyond medical treatment options alone. They provide practical tips and recommendations for first-line healthcare professionals when they treat a patient with a bleeding disorder. As many bleeding disorders are hereditary diseases, a diagnosis not only has impact on the patient, but on their family as well. A bleeding disorder also impacts family planning, pregnancy, and quality of life. Medical and psychological support is essential throughout life.

Finally, Michelle Lavin and Debra Pollard discuss some important topics for first-line healthcare providers to be aware of when they have a woman with a bleeding disorder in their practice, including the impact of a bleeding disorder on any medical invention, such as surgery, dental procedures or infertility treatment, but also on the use of pain medication.

In this second episode of the podcast series Women and Girls Bleed Too, Haematologist Dr. Roseline d’Oiron (Reference Centre for Haemophilia and RBD, Bicêtre Hospital AP-HP and University of Paris-Saclay in France) and Obstetrician/Gynaecologist Prof. Rezan Abdul-Kadir (The Royal Free Foundation Hospital in London, UK) discuss how to identify women and girls who are likely to have a bleeding disorder.

Prof. Abdul-Kadir addresses the steps she takes when she suspects a potential bleeding disorder in one of her patients. Dr. d’Oiron confirms it is key to get a clear understanding of the personal bleeding history and family history. There are several screening tools available to help assess the patient’s signs and symptoms. The experts discuss when a patient should be referred to a Haematologist, it is important to know that Haematologists are easily accessible for referral when in doubt.

Finally, Dr. d’Oiron and Prof. Abdul-Kadir address the types of testing that should and should not be done in first line. It turns out there are many misconceptions about laboratory testing for bleeding disorders. For example, contrary to common belief a normal aPTT and PT does not exclude a bleeding disorder. Furthermore, referring to a Haematologist for testing does not mean the patient should remain untreated. Starting basic treatment is crucial to limit the bleeding and address any iron deficiency as quickly as possible.

In this first episode of the podcast series Bleeding Disorders in Women and Girls: Women & Girls Bleed Too, Dr. Michelle Lavin (Haematologist at the National Coagulation Centre, St James’ Hospital, Dublin, Ireland) and Dr. Sarah O’Brien (Paediatric Haematologist at the Nationwide Children’s Hospital, Columbus, OH, USA) discuss how bleeding disorders occur in women and girls: Women & Girls Bleed Too. In clinical practice, sometimes girls can be forgotten about as bleeding disorders are more associated with males.

Dr. Lavin and Dr. O’Brien discuss the signs and symptoms of bleeding disorders and their impact on the quality of life of young girls, adolescents and adult women. Furthermore, they address how diagnosis may be easier in adults than in children, given the longer history of bleeding challenges. The experts also explore potential taboos in discussing these signs and symptoms with patients, considering intercultural differences and gender taboos, and the importance of normalising the conversation amongst healthcare professionals.

Finally, Dr. Lavin and Dr. O’Brien provide guidance on the next steps first-line healthcare providers should take when they see a patient with abnormal bleeding, including treatment initiation to limit the bleeding and address iron deficiency and referral to a haematologist for further assessment.