Danny Hsu on Interdisciplinary Toolkit for Gynecologic Bleeding on Anticoagulation
Danny Hsu, President of THANZ, reposted from ISTH on LinkedIn:
”New in JTH: Interdisciplinary Toolkit for Gynecologic Bleeding on Anticoagulation
Anticoagulation-related reproductive tract bleeding (AC-RTB) affects an estimated 20–60% of women and girls (WG+) on therapeutic anticoagulation.
Managing this balance between thrombosis and hemorrhage requires a shift from siloed practice to structured interdisciplinary collaboration.
A new “In Clinic” toolkit published in the Journal of Thrombosis and Haemostasis (JTH) by the Foundation for Women and Girls with Blood Disorders (FWGBD) outlines essential best practices.
Key Clinical Pearls:
The Team: Optimal management requires established channels between Hematology, Gynecology, and Adolescent Medicine.
Hormonal Management: Do not abruptly discontinue combined hormonal contraceptives (CHCs) at the time of acute VTE diagnosis.
Abrupt withdrawal precipitates bleeding just as anticoagulation is initiated; transition to alternative suppression should be managed carefully.
Screening: Every patient initiating anticoagulation requires screening for heavy menstrual bleeding (HMB) and iron deficiency.
DOAC Selection: Evidence suggests apixaban carries a lower risk of HMB compared to rivaroxaban.
This manuscript serves as a vital blueprint for establishing multidisciplinary clinics to reduce morbidity in this population.”
Quoting International Society on Thrombosis and Haemostasis (ISTH)‘s post:
”DYK: The Journal of Thrombosis and Haemostasis (JTH) in Clinic series offers case-based format for clinicians?
The latest article in this series shares clinical tools for managing gynecologic bleeding in patients on anticoagulation.
Learn more here.”
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