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  1. Article ; Online: Reproductive health and hemostatic issues in women and girls with congenital factor VII deficiency: A systematic review.

    Abdul-Kadir, Rezan / Gomez, Keith

    Journal of thrombosis and haemostasis : JTH

    2022  Volume 20, Issue 12, Page(s) 2758–2772

    Abstract: Background: Congenital factor VII (FVII) deficiency is an inherited bleeding disorder, with heterogenous bleeding symptoms. Women with FVII deficiency face hemostatic challenges during menstruation, ovulation, and childbirth. This systematic review ... ...

    Abstract Background: Congenital factor VII (FVII) deficiency is an inherited bleeding disorder, with heterogenous bleeding symptoms. Women with FVII deficiency face hemostatic challenges during menstruation, ovulation, and childbirth. This systematic review evaluated prevalence and management of bleeding symptoms associated with gynecological and obstetric issues in women with FVII deficiency.
    Methods: Databases (BIOSIS Previews, Current Contents Search, Embase, and MEDLINE) were searched for studies reporting FVII deficiency and gynecological or obstetric issues in women. Articles were screened using Joanna Briggs Institute checklists and relevant data extracted.
    Results: One hundred fourteen women were identified from 62 publications. Forty-six women had severe deficiency (FVII:C < 5% or <5 IU/dl). Heavy menstrual bleeding (HMB) was the most common bleeding symptom (n = 94; 82%); hospitalization and urgent medical/surgical interventions for acute HMB episodes were required in 16 women (14%). Seven women reported ovarian bleeding (6%); other bleeding symptoms varied. Patient management was inconsistent and included hemostatic and hormonal treatments. Only four women (7%) reporting vaginal bleeding during pregnancy. Postpartum hemorrhage (PPH) occurred following 12/45 deliveries (27%; 5 [42%] requiring blood transfusion) and was not necessarily prevented by prophylaxis (8 women).
    Conclusion: Women with congenital FVII deficiency have an increased risk of HMB, ovarian bleeding, and PPH, impacting quality of life. Recognition of a bleeding disorder as the cause is often delayed. Management of bleeding complications is heterogeneous due to lack of treatment guidelines. Harmonizing severity classification of FVII deficiency may help standardize treatment strategies and development of specific guidelines for these women.
    MeSH term(s) Pregnancy ; Female ; Humans ; Factor VII Deficiency/complications ; Factor VII Deficiency/diagnosis ; Hemostatics/therapeutic use ; Quality of Life ; Reproductive Health ; Factor VII ; Menorrhagia ; Postpartum Hemorrhage/diagnosis ; Postpartum Hemorrhage/epidemiology ; Postpartum Hemorrhage/therapy
    Chemical Substances Hemostatics ; Factor VII (9001-25-6)
    Language English
    Publishing date 2022-09-08
    Publishing country England
    Document type Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1111/jth.15872
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  2. Article ; Online: Planning Pregnancy and Birth in Women with Inherited Bleeding Disorders.

    Malinowski, A Kinga / Abdul-Kadir, Rezan

    Seminars in thrombosis and hemostasis

    2022  Volume 49, Issue 4, Page(s) 371–381

    Abstract: Inherited bleeding disorders are characterized by a diverse clinical phenotype within and across specific diagnoses. von Willebrand disease (VWD), hemophilia A, and hemophilia B comprise 95 to 97% of inherited bleeding disorders, with the remaining 3 to ... ...

    Abstract Inherited bleeding disorders are characterized by a diverse clinical phenotype within and across specific diagnoses. von Willebrand disease (VWD), hemophilia A, and hemophilia B comprise 95 to 97% of inherited bleeding disorders, with the remaining 3 to 5% attributed to rare bleeding disorders, including congenital fibrinogen disorders, factor deficiencies (affecting FII, FV, FV + FVIII, FVII, FX, FXI, and FXIII), and platelet function defects. The pregnancy, birth, and the puerperium may be adversely influenced in the setting of an inherited bleeding disorder depending on its type and clinical phenotype. Obstetric hemostatic challenges may sometimes also unmask the presence of a previously unknown inherited bleeding disorder. This review aims to address the approach to pregnancy and birth in the context of an inherited bleeding disorder and highlights the significance of multidisciplinary input into the care of these women.
    MeSH term(s) Pregnancy ; Female ; Humans ; Hemorrhage ; Hemostatics ; von Willebrand Diseases/diagnosis ; Fibrinogen ; Hemophilia A
    Chemical Substances Hemostatics ; Fibrinogen (9001-32-5)
    Language English
    Publishing date 2022-11-11
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 196901-8
    ISSN 1098-9064 ; 0094-6176
    ISSN (online) 1098-9064
    ISSN 0094-6176
    DOI 10.1055/s-0042-1758117
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  3. Article ; Online: Exploring social complexities of the COVID-19 pandemic on maternal anxiety: A mixed-methods observational cohort study.

    Anderson, Michelle / Pyart, Eleanor / Epstein, Audrey / Abdul-Kadir, Rezan

    European journal of midwifery

    2022  Volume 6, Page(s) 63

    Abstract: Introduction: The aim of this mixed-methods, small-scale observational cohort study was to examine if anxiety in pregnant women increased during the COVID-19 pandemic and to examine the subsequent impact on birth outcomes and psychological well-being. ... ...

    Abstract Introduction: The aim of this mixed-methods, small-scale observational cohort study was to examine if anxiety in pregnant women increased during the COVID-19 pandemic and to examine the subsequent impact on birth outcomes and psychological well-being. This research was conducted across two hospital sites in North London, with participation from 194 pregnant women.
    Methods: The GAD-7 questionnaire assessed for mild, moderate and high anxiety at one time point during the antenatal period and was repeated 6 weeks postnatally. Women with moderate to high scores on the GAD-7 were invited to participate in semi-structured interviews. The primary outcome measure was assessment of antenatal and postnatal anxiety. Secondary outcome measures assessed if women with moderate/high GAD-7 scores were more likely to develop a mental health condition during pregnancy, or up to 6 weeks postnatally, and if risk of preterm birth (<37 weeks gestation) and instrumental birth or cesarean section increased.
    Results: Pearson's correlation indicated a positive and significant correlation between the COVID-19 pandemic, and increased self-reported antenatal GAD-7 anxiety scores (r=0.47, n=194, p<0.001). GAD-7 scores were higher during pregnancy compared to the postnatal period [t(193)=4.63; p=0.001; 95% CI: 0.87-2.16]. Logistic regression did not show an increased likelihood of preterm birth [χ²(1, n=184)=0.999; p=0.971] or instrumental/cesarean section birth in women who scored moderately to highly on the antenatal GAD-7 [χ²(1, n=184)=2.73; p=0.165]. Qualitative analysis was carried out within a social constructionist framework and identified the following themes: anxiety, maternity care, social impact, and coping.
    Conclusions: Pregnant women self-reported an increase in antenatal anxiety during July 2020 to April 2021 of the COVID-19 pandemic. Moderate to high anxiety scores were not found to increase the likelihood of preterm birth and birth intervention or developing a mental health condition up to 6 weeks postnatally.
    Language English
    Publishing date 2022-10-11
    Publishing country Greece
    Document type Journal Article
    ISSN 2585-2906
    ISSN (online) 2585-2906
    DOI 10.18332/ejm/152200
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  4. Article: Planning Pregnancy and Birth in Women with Inherited Bleeding Disorders

    Malinowski, A. Kinga / Abdul-Kadir, Rezan

    Seminars in Thrombosis and Hemostasis

    (Maternal and Neonatal Hemostasis)

    2022  Volume 49, Issue 04, Page(s) 371–381

    Abstract: Inherited bleeding disorders are characterized by a diverse clinical phenotype within and across specific diagnoses. von Willebrand disease (VWD), hemophilia A, and hemophilia B comprise 95 to 97% of inherited bleeding disorders, with the remaining 3 to ... ...

    Series title Maternal and Neonatal Hemostasis
    Abstract Inherited bleeding disorders are characterized by a diverse clinical phenotype within and across specific diagnoses. von Willebrand disease (VWD), hemophilia A, and hemophilia B comprise 95 to 97% of inherited bleeding disorders, with the remaining 3 to 5% attributed to rare bleeding disorders, including congenital fibrinogen disorders, factor deficiencies (affecting FII, FV, FV + FVIII, FVII, FX, FXI, and FXIII), and platelet function defects. The pregnancy, birth, and the puerperium may be adversely influenced in the setting of an inherited bleeding disorder depending on its type and clinical phenotype. Obstetric hemostatic challenges may sometimes also unmask the presence of a previously unknown inherited bleeding disorder. This review aims to address the approach to pregnancy and birth in the context of an inherited bleeding disorder and highlights the significance of multidisciplinary input into the care of these women.
    Keywords bleeding disorders ; pregnancy ; delivery ; postpartum hemorrhage
    Language English
    Publishing date 2022-11-11
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 196901-8
    ISSN 1098-9064 ; 0094-6176
    ISSN (online) 1098-9064
    ISSN 0094-6176
    DOI 10.1055/s-0042-1758117
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  5. Article: Platelet storage pool disorder in pregnancy: Utilising thromboelastography to guide a risk-based delivery plan.

    Snow, Timothy Ac / Abdul-Kadir, Rezan A / Gomez, Keith / England, Adrian

    Obstetric medicine

    2021  Volume 15, Issue 2, Page(s) 133–135

    Abstract: We present a case of a 33-year-old woman in her third pregnancy diagnosed with platelet storage pool disorder who had previously suffered two postpartum major obstetric haemorrhages. Platelet storage pool disorder is a rare bleeding disorder where the ... ...

    Abstract We present a case of a 33-year-old woman in her third pregnancy diagnosed with platelet storage pool disorder who had previously suffered two postpartum major obstetric haemorrhages. Platelet storage pool disorder is a rare bleeding disorder where the platelet count is normal but platelet function is impaired due to deficiency of dense granules. A peripartum plan devised by an extensive multi-disciplinary team using principles for managing other bleeding and platelet function disorders helped minimise her risk of major haemorrhage. We also describe how point-of-care thromboelastography can help guide management and enable an individualised risk-benefit discussion with the woman about her anaesthetic choices.
    Language English
    Publishing date 2021-01-04
    Publishing country England
    Document type Case Reports
    ZDB-ID 2612229-7
    ISSN 1753-4968 ; 1753-495X
    ISSN (online) 1753-4968
    ISSN 1753-495X
    DOI 10.1177/1753495X20980254
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  6. Article ; Online: The risk of venous thromboembolism in early pregnancy loss: Review of the literature and current guidelines and the need for guidance - Communication from the SSC on Women's Health Issues for thrombosis and haemostasis.

    Collins, Anna / Memtsa, Maria / Kirk, Emma / Othman, Maha / Abdul Kadir, Rezan

    Journal of thrombosis and haemostasis : JTH

    2022  Volume 20, Issue 3, Page(s) 767–776

    Abstract: Background: Thromboembolic disease is one of the major causes of mortality and morbidity in pregnancy and the puerperium, with 1 death per 100 000 births attributed to venous thromboembolism (VTE). Factors associated with development of thrombosis are ... ...

    Abstract Background: Thromboembolic disease is one of the major causes of mortality and morbidity in pregnancy and the puerperium, with 1 death per 100 000 births attributed to venous thromboembolism (VTE). Factors associated with development of thrombosis are all present in pregnancy, with some of these changes seen from conception.
    Objective: Given how common early pregnancy loss is, the aim of this review is to evaluate the uncertainty surrounding the risk of VTE following early pregnancy loss and termination of pregnancy.
    Methods: A structured literature search was conducted to identify existing evidence as well as international pregnancy-specific guidelines regarding assessment and prevention of VTE risk in pregnant women. This review was reviewed, critiqued, and approved by all members of the International Society on Thrombosis and Haemostasis subcommittee for Women's Health Issues in Thrombosis and Haemostasis.
    Results: Four published original research studies, one clinical comment paper, and six guidelines were reviewed. Despite clear evidence of the increased risk of VTE in pregnancy, there is a lack of guidance regarding evaluation and management after early pregnancy loss.
    Conclusion: International collaborative research to determine the risk of VTE and its prevention in women undergoing surgical termination of pregnancy or following surgical management of early pregnancy loss is urgently needed. Pregnancy-specific risk assessment taking into account preexisting risk factors is advocated. Education of health care professionals involved in early pregnancy care and guidance on management, albeit based on limited existing evidence, are necessary to highlight the need for individualized care.
    MeSH term(s) Abortion, Spontaneous/etiology ; Female ; Hemostasis ; Humans ; Pregnancy ; Pregnancy Complications, Cardiovascular/diagnosis ; Pregnancy Complications, Cardiovascular/therapy ; Risk Factors ; Thrombosis/complications ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/prevention & control ; Women's Health
    Language English
    Publishing date 2022-01-07
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1111/jth.15621
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  7. Article ; Online: Corrigendum to Examining international practices in the management of pregnant women with von Willebrand disease [J Thromb Haemost. 2022 Jan;20(1):82-91].

    Lavin, Michelle / Luceros, Analia Sánchez / Kouides, Peter / Abdul-Kadir, Rezan / O'Donnell, James S / Baker, Ross I / Othman, Maha / Haberichter, Sandra L

    Journal of thrombosis and haemostasis : JTH

    2023  Volume 21, Issue 4, Page(s) 1068

    Language English
    Publishing date 2023-02-23
    Publishing country England
    Document type Published Erratum
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1016/j.jtha.2023.01.020
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  8. Article ; Online: Postmortem diagnosis of severe factor X deficiency in a fetus with intracranial hemorrhage resulting in intrauterine death.

    Krumb, Evelien / Mehta, Nishita / Hutchinson, Ciaran / Jradeh, Bilal / Jaslowska, Ewa / Gomez, Keith / Abdul-Kadir, Rezan

    Journal of thrombosis and haemostasis : JTH

    2023  Volume 21, Issue 12, Page(s) 3501–3507

    Abstract: In patients with severe congenital factor X deficiency, spontaneous intracranial hemorrhage (ICH) is particularly frequent in early childhood. We describe a case of fetal death at 26 weeks due to massive ICH. Gene panel analysis of postmortem samples ... ...

    Abstract In patients with severe congenital factor X deficiency, spontaneous intracranial hemorrhage (ICH) is particularly frequent in early childhood. We describe a case of fetal death at 26 weeks due to massive ICH. Gene panel analysis of postmortem samples revealed homozygosity for a pathologic F10 gene variant (c.1210T>C, p.Cys404Arg), which impedes correct folding of the catalytic serine protease domain and, therefore, causes a significant reduction in FX levels. The parents, not consanguineous but of the same ethnic community, were found to be heterozygous for this variant and did not have any personal or family history of abnormal bleeding. To the best of our knowledge, this is the first reported case of severe FX deficiency resulting in ICH diagnosed through postmortem genetic analysis. It illustrates the importance of exploring the etiology of fetal or neonatal ICH, which may impact future pregnancies, and the treatment of a potential coagulopathy in the child.
    MeSH term(s) Infant, Newborn ; Child ; Pregnancy ; Female ; Humans ; Child, Preschool ; Factor X Deficiency/complications ; Factor X Deficiency/diagnosis ; Factor X Deficiency/genetics ; Intracranial Hemorrhages/genetics ; Intracranial Hemorrhages/diagnosis ; Hemorrhage/genetics ; Fetal Death/etiology ; Fetus/pathology ; Factor X
    Chemical Substances Factor X (9001-29-0)
    Language English
    Publishing date 2023-09-09
    Publishing country England
    Document type Case Reports
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1016/j.jtha.2023.08.027
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  9. Article ; Online: Hematologic characteristics and coagulopathy in pregnancy with COVID-19 succeeding the first wave: a multicenter retrospective cross-sectional study.

    Othman, Maha / Nemeti, Georgiana / Solow, Marissa / Cruciat, Gheorghe / Muresan, Daniel / Chaikh Sulaiman, Mariam Suzana / Thaker, Shivani / Abdul-Kadir, Rezan / Malinowski, A Kinga

    Research and practice in thrombosis and haemostasis

    2024  Volume 8, Issue 1, Page(s) 102339

    Abstract: Background: Early reports have demonstrated an association of COVID-19 infection during pregnancy and postpartum period with coagulopathy and bleeding complications and indicated that pregnant people with COVID-19 are more likely to experience ... ...

    Abstract Background: Early reports have demonstrated an association of COVID-19 infection during pregnancy and postpartum period with coagulopathy and bleeding complications and indicated that pregnant people with COVID-19 are more likely to experience coagulopathy and venous thromboembolism. A recent report concerning such complications during the first wave of the pandemic was reassuring; however, no publications have evaluated these issues in the context of increased illness severity with the emergence of SARS-CoV-2 variants of concern.
    Objectives: We performed a retrospective, multinational cohort study in Canada, Romania, and the United Kingdom, aiming to provide a comprehensive analysis of the hematologic test characteristics of pregnancies affected by COVID-19 after the first wave of the pandemic.
    Results: Three-hundred-seventy patients were evaluated. Markers of inflammation and endothelial dysfunction were significantly elevated, in keeping with observations in the nonpregnant population. Reassuringly, despite more severe disease noted in succeeding waves of the pandemic, there was no significant evidence of COVID-19-associated coagulopathy, and overall, no association was demonstrated between isolated coagulation abnormalities and bleeding risk. Notably, fibrinogen below 2g/L was again linked with the risk of postpartum hemorrhage. Finally, venous thromboembolism risk was low but noted more frequently in those with severe illness despite thromboprophylaxis.
    Conclusion: Our findings add valuable insights into the nature of hematologic test characteristics, bleeding, and thrombotic complications for those affected with COVID-19 in pregnancy, reassuring readers of the low incidence of bleeding and thrombotic complications but inviting further debate as to the degree of thromboprophylaxis that may benefit the subgroup with severe disease.
    Language English
    Publishing date 2024-02-05
    Publishing country United States
    Document type Journal Article
    ISSN 2475-0379
    ISSN (online) 2475-0379
    DOI 10.1016/j.rpth.2024.102339
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  10. Article ; Online: Management of pregnancy and delivery in congenital fibrinogen disorders: communication from the ISTH SSC Subcommittee on Factor XIII and Fibrinogen.

    Casini, Alessandro / Abdul Kadir, Rezan / Abdelwahab, Magy / Manco-Johnson, Marilyn J / Raut, Sanj / Ross, Cecil / de Moerloose, Philippe / Santoro, Cristina / Acharya, Suchitra

    Journal of thrombosis and haemostasis : JTH

    2024  Volume 22, Issue 5, Page(s) 1516–1521

    Abstract: Congenital fibrinogen disorders (CFDs) are a heterogeneous group of rare congenital quantitative and/or qualitative fibrinogen deficiencies. The spectrum of molecular anomalies is broad, leading to several subtypes of fibrinogen disorders (ie, ... ...

    Abstract Congenital fibrinogen disorders (CFDs) are a heterogeneous group of rare congenital quantitative and/or qualitative fibrinogen deficiencies. The spectrum of molecular anomalies is broad, leading to several subtypes of fibrinogen disorders (ie, afibrinogenemia, hypofibrinogenemia, dysfibrinogenemia, and hypodysfibrinogenemia). Pregnancy in women with CFDs is a high-risk clinical situation, with an increased tendency for miscarriages, bleeding, and thrombosis. Even though it is well established that management of such pregnancies requires a multidisciplinary approach involving specialists (hematologists and maternal/fetal medicine experts with expertise in the management of inherited bleeding disorders), specific guidelines are lacking. In this International Society on Thrombosis and Haemostasis (ISTH) Scientific and Standardization Committee communication, we aim to propose an expert consensus opinion with literature evidence where available on the strategy for management of pregnancy, delivery, and puerperium in CFDs.
    MeSH term(s) Humans ; Pregnancy ; Female ; Afibrinogenemia/diagnosis ; Afibrinogenemia/blood ; Afibrinogenemia/therapy ; Pregnancy Complications, Hematologic/blood ; Pregnancy Complications, Hematologic/diagnosis ; Pregnancy Complications, Hematologic/therapy ; Fibrinogen/metabolism ; Fibrinogen/therapeutic use ; Factor XIII/metabolism ; Delivery, Obstetric ; Consensus
    Chemical Substances Fibrinogen (9001-32-5) ; Factor XIII (9013-56-3)
    Language English
    Publishing date 2024-01-22
    Publishing country England
    Document type Journal Article ; Practice Guideline ; Review
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1016/j.jtha.2024.01.008
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