In July, researchers from Duke University published a study on the incidence of hemorrhaging and other complications in women with von Willebrand disease (VWD) who had undergone a hysterectomy. The lead author of the report was Andra H. James, MD, Department of Obstetrics and Gynecology and Department of Surgery, Duke University Medical Center, Durham, NC. The study was funded in part through a grant from the National Institutes of Health.
James and her colleagues queried The United States Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality for the years 1988–2004 for all hysterectomies for nonmalignant conditions. In all, 545 of the 1,358,133 hysterectomies were conducted for women with VWD. They found that women with VWD were more likely to experience bleeding during and after surgery than unaffected women (2.75% vs. 0.89%) and were much more likely to need a transfusion (7.34% vs. 2.13%). These transfusions included packed red cells, platelets and factor products including, “possibly,” von Willebrand factor or factor VIII concentrates.
“While the risk of bleeding complications from hysterectomy in women with VWD is smaller than previously reported, women with VWD did experience significantly more bleeding complications than women without VWD. Nonetheless, for women who have completed childbearing, the risks of hysterectomy may be acceptable,” concluded the authors.
The study, “Complications of Hysterectomy in Women with von Willebrand disease,” was published in the July 2009 issue of Haemophilia.