28 Chapter 2 Table 2: Assesment of MINORS criteria for all included studies (N=12). De Wee et al3 Ragni et al22 James et al19 Kadir et al21 A clearly stated aim 2 2 2 2 Inclusion of consecutive patients 2 2 2 2 Prospective collection of data 2 2 0 2 Endpoints appropriate to the aim of the study 2 2 2 2 Unbiased assessment of the study endpoint 1 1 1 1 Follow-up period appropriate to the aim of the study 1 1 0 2 Loss to follow-up less than 5% 1 1 0 1 Prospective calculation of the study size 0 0 0 0 An adequate control group NA NA NA NA Contemporary groups NA NA NA NA Baseline equivalence of groups NA NA NA NA Adequate statistical analyses NA NA NA NA Total MINORS score 11 11 7 12 The items are scored 0 (not reported), 1 (reported but inadequate), 2 (reported but adequate), NA (Not Applicable) The global ideal score is 16 for noncomparative studies. Bleeding complications in relation to prophylactic management in hysterectomy or EA Overall, in 4% (24/661) of all the hysterectomy cases prophylaxis was described. (20, 22, 23) During hysterectomies, 13% (3/24) of bleeding complications occurred in women who received prophylaxis versus 14% (87/637) bleeding complications occurred without mentioning prophylaxis. A retrospective study included 5 VWD patients (type 1, 2 and 3) who underwent abdominal hysterectomies because of HMB. (23) Three patients had bleeding complications; one vault hematoma was described after receiving no prophylaxis (VWD type 1) which was managed through conservative treatment; one wound hematoma after desmopressin infusion as prophylaxis (VWD type 1) which required surgical drainage; and lastly one postoperative bleed and hematuria occurred despite VWF concentrate as prophylaxis (VWD type 3), for which the woman required 4 units of blood transfusion. (23) All (100%, 30/30) EA cases (15-20, 22) received prophylaxis: tranexamic acid (N=10; type not specified, type 1 or type 3), (17, 20) desmopressin (N=8; type not specified or type 1), (16, 17) VWF/ FVIII concentrate (N= 8; type 1, type 2A, type 2N, or acquired), (16, 22) unspecified (N=2; type 1), (18) buserelin nasal spray (N=1; type 1) (19) and plasma transfusion (N=1; type not specified). (15) None of these 30 patients (0%) with VWD experienced bleeding complications.
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