Disorders of Hemostasis and Thrombosis in Women's Health

Endogenous mechanisms of uterine hemostasis protect women from the bleeding challenges of miscarriage, childbirth, and menstruation. With failure of normal uterine hemostasis at the time of childbirth there is the potential for postpartum hemorrhage. Women with bleeding disorders are at particular risk. Dysregulation of the normal mechanisms of hemostasis during pregnancy may result in either venous or arterial thromboembolism. With failure of normal hemostasis during the menstrual cycle there is the potential for heavy menstrual bleeding (menorrhagia). This session will address uterine hemostasis by discussing the unique needs of women with bleeding disorders, risk factors for venous and arterial thromboembolism during pregnancy, and heavy menstrual bleeding.

Dr. Gernsheimer will discuss inherited and acquired bleeding disorders in pregnancy, including the prevention and management of bleeding complications for both mother and fetus at the time of delivery.

Dr. Cushman will discuss both the overlapping and unique risk factors for venous and arterial thromboembolism in pregnancy, focusing primarily on venous thromboembolism and stroke. She will briefly touch on the treatment strategies for each and how they are modified in pregnancy.

Dr. James will discuss what the hematologist needs to know about normal and heavy menstrual bleeding. She will discuss the management of heavy menstrual bleeding for both women with underlying bleeding disorders and women on anticoagulation.