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Nathan Connell: Key Clinical Advances in Heavy Menstrual Bleeding and Postpartum Hemorrhage from ISTH 2026
Nathan Connell/LinkedIn
Jul 12, 2026, 15:45

Nathan Connell: Key Clinical Advances in Heavy Menstrual Bleeding and Postpartum Hemorrhage from ISTH 2026

Nathan Connell, Clinical Chief of Hematology at Brigham and Women’s Faulkner Hospital, shared on LinkedIn:

”Yesterday’s ISTH 2026 session on heavy menstrual bleeding and postpartum hemorrhage highlighted both the scale of the unmet need and the breadth of innovation emerging across diagnosis, treatment, and health-system delivery.

Several key findings included:

  • Among 192 adolescents presenting with heavy menstrual bleeding, nearly one-third had an underlying bleeding disorder, most commonly a platelet function disorder or von Willebrand disease. The ISTH Bleeding Assessment Tool showed useful discriminatory performance, reinforcing the value of a structured bleeding history in guiding laboratory evaluation.
  • A proteome-wide study identified a 34-protein signature that strongly predicted incident heavy menstrual bleeding and outperformed clinical and genetic models. External validation will be essential, but the work points toward more objective biologic risk stratification.
  • In a large real-world cohort of pregnancies affected by von Willebrand disease, delayed postpartum hemorrhage was associated with lower VWF and factor VIII levels, as well as retained placenta, placenta previa, infection, laceration, anemia, and a pre-existing bleeding phenotype. Risk cannot be defined by a single factor level or delivery plan. It requires integrated hematologic and obstetric assessment, with surveillance extending beyond the first 24 hours after delivery.
  • A prospective intervention in Mozambique demonstrated substantial reductions in postpartum hemorrhage and maternal mortality after expansion of transfusion and cryoprecipitate capacity. Although the observational findings require cautious interpretation, they illustrate the potential impact of strengthening basic blood-product infrastructure in resource-constrained settings.
  • Preclinical data for HMB-003, a long-acting direct plasmin inhibitor, suggested the possibility of sustained antifibrinolytic coverage across an entire menstrual period with a single subcutaneous dose.

The broader message is that heavy menstrual bleeding and postpartum hemorrhage should not be treated as isolated reproductive health problems.

They are often manifestations of underlying hemostatic vulnerability, amplified by obstetric, structural, and health-system factors.

Progress will require earlier recognition, better risk stratification, multidisciplinary care, access to effective hemostatic therapies, and systems designed to respond rapidly when bleeding occurs.”

Stay updated with Hemostasis Today.

bleeding disorders Health heavy menstrual bleeding Hematology Hemostasis Hemostasis News Hemostasis Today ISTH 2026 Medicine Nathan Connell Postpartum Hemorrhage VWD VWF
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