{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:21:14Z","timestamp":1789017674450,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2008,9,5]],"date-time":"2008-09-05T00:00:00Z","timestamp":1220572800000},"content-version":"vor","delay-in-days":2865,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2000,11]]},"abstract":"<jats:p>Type 1 von Willebrand disease (vWD) is generally regarded clinically as \u2018mild\u2019 and the obstetrical\u2013gynaecological features have not been fully described. We administered a patient questionnaire and provider survey of the medical and quality of life aspects of childbirth and menstruation to 99 type 1 vWD patients and compared the patients presently menstruating (<jats:italic>n<\/jats:italic>=81) to a cohort of 150 menstruating females in the general population. The following measurements had a statistically higher proportion in the vWD group: number of tampons\/towels used for a typical menstrual cycle (<jats:italic>P<\/jats:italic>=0.002); percentage reporting that clothes are stained by menses (<jats:italic>P<\/jats:italic>\u2003= 0.001); past or present history of anaemia (<jats:italic>P<\/jats:italic>\u2003= 0.001); childbirth\u2010related bleeding (<jats:italic>P<\/jats:italic>=0.001); and childbirth\u2010related bleeding necessitating RBC transfusion (<jats:italic>P<\/jats:italic>=0.002). Quality of life assessment of the impact of menses in both of the above cohorts was measured by a Likert scale using seven quality of life parameters. Compared to the control group, the vWD patients had a significantly higher score, with <jats:italic>P<\/jats:italic>\u2010values of &lt;\u20030.0001 for each parameter. Hormonal interventions for menorrhagia in the vWD patients were \u2264\u200350% effective. Menorrhagia resulted in red blood cell transfusions in 6% of patients, dilatation and curettage in 17% and hysterectomy in 13%. Despite the common connotation of type 1 vWD as clinically \u2018mild\u2019, childbirth and the monthly challenge to haemostasis presented by menstruation result in a substantial degree of morbidity in females with type 1 vWD. These results support the rationale for ongoing international efforts to increase awareness of vWD as a cause for menorrhagia and to improve the quality of life in females with known vWD.<\/jats:p>","DOI":"10.1046\/j.1365-2516.2000.00447.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T23:02:35Z","timestamp":1047423755000},"page":"643-648","source":"Crossref","is-referenced-by-count":177,"title":["Gynaecological and obstetrical morbidity in women with type I von Willebrand disease: results of a patient survey"],"prefix":"10.1111","volume":"6","author":[{"given":"P. A.","family":"Kouides","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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