Key result
Periprocedural hemostatic prophylaxis in BDUC patients was associated with a 4.1% bleeding rate during procedures compared with 10% without prophylaxis, though postpartum bleeding remained high at 23.5%.
Why the study?
Does periprocedural and peripartum hemostatic prophylaxis reduce major or clinically relevant nonmajor bleeding in patients with bleeding disorder of unknown cause (BDUC)?
Does periprocedural and peripartum hemostatic prophylaxis reduce major or clinically relevant nonmajor bleeding in patients with bleeding disorder of unknown cause (BDUC)?
Answers are grounded in this paper and cite their sources.
Current periprocedural and peripartum hemostatic prophylaxis in patients with bleeding disorder of unknown cause reduces procedural bleeding but remains insufficient, particularly for preventing postpartum hemorrhage, underscoring the urgent need for prospective trials.
Sixty to seventy percent of persons with a clinically relevant bleeding tendency who are referred to hemostasis experts are classified as having a bleeding disorder of unknown cause (BDUC) when a diagnosis cannot be established after extensive laboratory testing [1]. A frequent (presenting) symptom in persons with BDUC is periprocedural bleeding during surgical and dental procedures as well as postpartum hemorrhage, next to less severe bleeding events such as easy bruising and mucocutaneous bleeding, eg, epistaxis and heavy menstrual bleeding [2–5].
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Mussert et al. (2024) conducted an editorial in Bleeding disorder of unknown cause (BDUC) (n=127). Periprocedural hemostatic prophylaxis (antifibrinolytic agents, desmopressin, and/or platelet transfusions) vs. No hemostatic prophylaxis was evaluated on Major or clinically relevant nonmajor periprocedural bleeding according to ISTH criteria. Periprocedural hemostatic prophylaxis in BDUC patients was associated with a 4.1% bleeding rate during procedures compared with 10% without prophylaxis, though postpartum bleeding remained high at 23.5%.
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