{"id":1088,"date":"2023-08-14T07:52:15","date_gmt":"2023-08-14T07:52:15","guid":{"rendered":"https:\/\/new.vwdtest.com\/cz\/?page_id=1088"},"modified":"2024-07-18T18:16:09","modified_gmt":"2024-07-18T18:16:09","slug":"vwd-and-gynaecology-obstetrics","status":"publish","type":"page","link":"https:\/\/vwdtest.com\/cz\/vwd-and-gynaecology-obstetrics\/","title":{"rendered":"vWch A GYNEKOLOGIE \/ PORODNICTV\u00cd"},"content":{"rendered":"
\n
Poruchy krv\u00e1cen\u00ed, v\u010detn\u011b von Willebrandovy choroby (vWch)<\/a>, jsou podle odhad\u016f zodpov\u011bdn\u00e9 za siln\u00e9 menstrua\u010dn\u00ed krv\u00e1cen\u00ed (SMK) u ka\u017ed\u00e9 p\u00e1t\u00e9 \u017eeny s t\u00edmto onemocn\u011bn\u00edm.1 <\/sup>Poruchy krv\u00e1cen\u00ed jsou tak\u00e9 v\u00fdznamn\u00fdm rizikov\u00fdm faktorem nadm\u011brn\u00e9ho krv\u00e1cen\u00ed p\u0159i porodu a po porodu. Navzdory prominentn\u00ed roli poruch krv\u00e1cen\u00ed jako p\u0159\u00ed\u010diny nadm\u011brn\u00e9ho vagin\u00e1ln\u00edho krv\u00e1cen\u00ed a skute\u010dnosti, \u017ee vWch je nej\u010dast\u011bj\u0161\u00ed krv\u00e1civou poruchou, je na vWch testov\u00e1n pouze zlomek \u017een, kter\u00e9 vykazuj\u00ed nadm\u011brn\u00e9 vagin\u00e1ln\u00ed krv\u00e1cen\u00ed.2<\/sup> <\/h5>\n<\/div>\n\n\"vWch\r\n\n\n
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Vzhledem k nedostate\u010dn\u00e9 informovanosti a vzd\u011bl\u00e1n\u00ed z\u016fst\u00e1v\u00e1 vWch \u010dasto nediagnostikov\u00e1na nebo je diagn\u00f3za opo\u017ed\u011bna. Bez diagn\u00f3zy a l\u00e9\u010dby mohou tyto \u017eeny poci\u0165ovat v\u00e1\u017en\u00e9 fyzick\u00e9 a psychick\u00e9 n\u00e1sledky SMK, v\u010detn\u011b \u00fanavy, an\u00e9mie, \u00fazkosti a deprese.1<\/sup><\/p>\n<\/div>\n\n

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Role gynekolog\u016f a porodn\u00edk\u016f<\/h3>\n<\/div>\n\n
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T\u00e9m\u011b\u0159 v\u0161echny \u017eeny s vWch v reproduk\u010dn\u00edm v\u011bku za\u017e\u00edvaj\u00ed nadm\u011brn\u00e9 vagin\u00e1ln\u00ed krv\u00e1cen\u00ed.3<\/sup> Siln\u00e1 menstruace je nav\u00edc \u010dasto prvn\u00edm n\u00e1padn\u00fdm krv\u00e1civ\u00fdm p\u0159\u00edznakem, kdy\u017e d\u00edvky s vWch vstupuj\u00ed do puberty. Jako gynekolog nebo porodn\u00edk jste \u010dasto prvn\u00edm poskytovatelem zdravotn\u00ed p\u00e9\u010de, se kter\u00fdm tyto d\u00edvky nebo jejich pe\u010dovatel\u00e9 diskutuj\u00ed o rozs\u00e1hl\u00e9m sklonu ke krv\u00e1cen\u00ed. Va\u0161e konzultace proto p\u0159edstavuj\u00ed prvn\u00ed p\u0159\u00edle\u017eitost, jak pomoci identifikovat pacientky, kter\u00e9 mohou m\u00edt prosp\u011bch z dal\u0161\u00edho diagnostick\u00e9ho hodnocen\u00ed poruchy krv\u00e1cen\u00ed. Tato p\u0159\u00edle\u017eitost je zvl\u00e1\u0161t\u011b d\u016fle\u017eit\u00e1 ve spole\u010dnostech, kter\u00e9 stigmatizuj\u00ed vagin\u00e1ln\u00ed krv\u00e1cen\u00ed, nebo pro pacientky, kter\u00e9 se mohly st\u00e1t necitliv\u00fdmi na silnou menstruaci a mohou se c\u00edtit nevysly\u0161eny nebo \u0161patn\u011b pochopeny.2<\/sup> Nav\u00edc, proto\u017ee krv\u00e1civ\u00e9 poruchy, jako je vWch, jsou d\u011bdi\u010dn\u00e9, diagnostika vWch \u010dasto pom\u00e1h\u00e1 identifikovat dal\u0161\u00ed ohro\u017een\u00e9 \u010dleny rodiny.<\/p>\n<\/div>\n\n

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A\u010dkoli je zv\u00fd\u0161en\u00ed informovanosti mezi poskytovateli zdravotn\u00ed p\u00e9\u010de a pacienty nejd\u016fle\u017eit\u011bj\u0161\u00edm krokem p\u0159i identifikaci pacientek s rizikem krv\u00e1cen\u00ed, diagnostika vWch z\u016fst\u00e1v\u00e1 vzhledem ke slo\u017eitosti diagnostick\u00e9ho procesu n\u00e1ro\u010dn\u00fdm \u00fakolem.2<\/sup> Pokud se u n\u011bkter\u00e9 z va\u0161ich pacientek v posledn\u00ed dob\u011b objevilo nadm\u011brn\u00e9 vagin\u00e1ln\u00ed krv\u00e1cen\u00ed, doporu\u010dujeme, abyste pacientku po\u017e\u00e1dali, aby zdokumentovala menstruaci pomoc\u00ed na\u0161eho grafu hodnocen\u00ed menstruace<\/a>. M\u016f\u017eete tak\u00e9 navrhnout proveden\u00ed na\u0161eho testu krv\u00e1cen\u00ed<\/a> u va\u0161\u00ed pacientky. Test v\u00e1m podpo\u0159\u00ed prvn\u00ed rozhodnut\u00ed, zda jsou pot\u0159eba dal\u0161\u00ed vy\u0161et\u0159en\u00ed \u2013 a m\u016f\u017ee zm\u011bnit \u017eivot va\u0161\u00ed pacientky !<\/p>\n<\/div>\n\n

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Existuje n\u011bkolik mo\u017enost\u00ed l\u00e9\u010dby pro \u017eeny s vWch a SMK a jsou k dispozici pokyny pro l\u00e9\u010dbu SMK v d\u016fsledku vWch.4<\/sup> L\u00e9\u010dba by m\u011bla b\u00fdt individualizov\u00e1na s ohledem na faktory, jako je v\u011bk, \u017eivotn\u00ed styl, pt\u0159eby v t\u011bhotenstv\u00ed a dal\u0161\u00ed preference pacientky. Je d\u016fle\u017eit\u00e9 si uv\u011bdomit, \u017ee n\u011bkter\u00e1 opat\u0159en\u00ed\/l\u00e9\u010dba, nap\u0159. antikoncepce, jsou \u010dasto \u00fa\u010dinn\u00e1 p\u0159i zm\u00edrn\u011bn\u00ed SMK, ale neochr\u00e1n\u00ed va\u0161e pacientky s vWch p\u0159ed krv\u00e1cen\u00edm po traumatu nebo b\u011bhem c<\/a>hirurgick\u00e9ho z\u00e1kroku<\/a>, proto je z\u00e1sadn\u00ed \u00fapln\u00e1 diagn\u00f3za. Nadm\u011brn\u00e9 vagin\u00e1ln\u00ed krv\u00e1cen\u00ed se nav\u00edc \u010dasto setk\u00e1v\u00e1 se stigmatizac\u00ed a propou\u0161t\u011bn\u00edm. Spolu s omezen\u00edmi v ka\u017edodenn\u00edm \u017eivot\u011b, fyzick\u00fdch aktivit\u00e1ch a soci\u00e1ln\u00edch interakc\u00edch zp\u016fsoben\u00fdch SMK m\u016f\u017ee tento nedostatek uzn\u00e1n\u00ed znamenat pro va\u0161e pacientky velkou ment\u00e1ln\u00ed z\u00e1t\u011b\u017e<\/a>.5,6<\/sup> Bez dostate\u010dn\u00e9 soci\u00e1ln\u00ed podpory se u va\u0161ich pacientek s vWch mohou dokonce rozvinout \u00fazkosti a deprese.<\/p>\n<\/div>\n\n

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\u017deny s vWch mohou m\u00edt \u00fasp\u011b\u0161n\u00e1 t\u011bhotenstv\u00ed<\/a> a porodit zdrav\u00e9 d\u011bti. Bez diagn\u00f3zy a l\u00e9\u010dby v\u0161ak mohou b\u011bhem porodu a po n\u011bm zaznamenat nadm\u011brn\u00e9 krv\u00e1cen\u00ed. Proto je pro zaji\u0161t\u011bn\u00ed norm\u00e1ln\u00edho porodu nezbytn\u00e9 pe\u010dliv\u00e9 pl\u00e1nov\u00e1n\u00ed a monitorov\u00e1n\u00ed. Kdykoli je to mo\u017en\u00e9, t\u011bhotenstv\u00ed a porod by m\u011bly b\u00fdt projedn\u00e1ny a napl\u00e1nov\u00e1ny s dostate\u010dn\u00fdm p\u0159edstihem a spole\u010dn\u011b s multidisciplin\u00e1rn\u00edm t\u00fdmem v\u010detn\u011b specializovan\u00e9ho hematologa v l\u00e9\u010debn\u00e9m centru<\/a>.8,9<\/sup> VWDtest tak\u00e9 nab\u00edz\u00ed dal\u0161\u00ed informace o etiologii, diagn\u00f3ze<\/a> a l\u00e9\u010den\u00ed vWch<\/a> a tak\u00e9 vhled do typick\u00fdch situac\u00ed pacient\u016f s VWD.<\/p>\n<\/div>\n\n

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Reference<\/h6>\n<\/div>\n\n
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  1. Kadir RA et al. Lancet <\/em>1998; 351:485-9.<\/li>\n<\/div>\n\n
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  2. Corrales-Medina FF et al. Blood Rev<\/em> 2023; 58:101018.<\/li>\n<\/div>\n\n
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  3. de Wee EM, et al. Thromb Haemost<\/em> 2012; 108:683-92.<\/li>\n<\/div>\n\n
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  4. Connell NT et al. Blood Adv<\/em> 2021; 5:301-25.<\/li>\n<\/div>\n\n
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  5. VanderMeulen H, et al. Hematology Am Soc Hematol Educ Program<\/em> 2022 1: 631-6.<\/li>\n<\/div>\n\n
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  6. Sanigorska A, et al. Res Pract Thromb Haemost<\/em> 2022; 6:e12652.<\/li>\n<\/div>\n\n
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  7. Roberts JC, et al. Haemophilia <\/em>2022; doi: 10.1111\/hae.14725.<\/li>\n<\/div>\n\n
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  8. Leebeek FWG, et al. Blood <\/em>2020; 136:2143-50.<\/li>\n<\/div>\n\n
    \n
  9. Janbain M and Kouides P Int J Womens Health<\/em> 2022; 14:1307-13.<\/li>\n<\/div><\/ol>\n<\/div>","protected":false},"excerpt":{"rendered":"

    Poruchy krv\u00e1cen\u00ed, v\u010detn\u011b von Willebrandovy choroby (vWch), jsou podle odhad\u016f zodpov\u011bdn\u00e9 za siln\u00e9 menstrua\u010dn\u00ed krv\u00e1cen\u00ed (SMK) u ka\u017ed\u00e9 p\u00e1t\u00e9 \u017eeny s t\u00edmto onemocn\u011bn\u00edm.1 Poruchy krv\u00e1cen\u00ed jsou tak\u00e9 v\u00fdznamn\u00fdm rizikov\u00fdm faktorem nadm\u011brn\u00e9ho krv\u00e1cen\u00ed p\u0159i porodu a po porodu. Navzdory prominentn\u00ed roli poruch krv\u00e1cen\u00ed jako p\u0159\u00ed\u010diny nadm\u011brn\u00e9ho vagin\u00e1ln\u00edho krv\u00e1cen\u00ed a skute\u010dnosti, \u017ee vWch je nej\u010dast\u011bj\u0161\u00ed krv\u00e1civou poruchou, […]<\/p>\n","protected":false},"author":1,"featured_media":1096,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false},"acf":[],"yoast_head":"\nvWch A GYNEKOLOGIE \/ PORODNICTV\u00cd - Czech Republic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/vwdtest.com\/cz\/vwd-and-gynaecology-obstetrics\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"vWch A GYNEKOLOGIE \/ PORODNICTV\u00cd - Czech Republic\" \/>\n<meta property=\"og:description\" content=\"Poruchy krv\u00e1cen\u00ed, v\u010detn\u011b von Willebrandovy choroby (vWch), jsou podle odhad\u016f zodpov\u011bdn\u00e9 za siln\u00e9 menstrua\u010dn\u00ed krv\u00e1cen\u00ed (SMK) u ka\u017ed\u00e9 p\u00e1t\u00e9 \u017eeny s t\u00edmto onemocn\u011bn\u00edm.1 Poruchy krv\u00e1cen\u00ed jsou tak\u00e9 v\u00fdznamn\u00fdm rizikov\u00fdm faktorem nadm\u011brn\u00e9ho krv\u00e1cen\u00ed p\u0159i porodu a po porodu. 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