Women's Hemostasis & Thrombosis Clinic

The Women’s Hemostasis and Thrombosis Clinic at Duke was formally organized in July of 2000 in response to the needs of women with bleeding and clotting disorders. Starting in 2002, the Centers for Disease Control and Prevention’s Division of Hereditary Blood Disorders recognized and began funding Duke’s Comprehensive Hemostasis and Thrombosis Center, in part because of the important work of the Women’s Clinic. The Women’s Clinic has a Gynecologic Program that serves the needs of women who have a bleeding disorder or are on anticoagulation and require management of menorrhagia. The Obstetric Program primarily serves the needs of women who have a bleeding or clotting disorder and are pregnant or desire a pregnancy.

Since its inception in 2000, the Obstetric Program of the Women’s Hemostasis and Thrombosis has been supported by the Division of Maternal Fetal Medicine in the Department of Obstetrics and Gynecology and the Division of Hematology in the Department of Medicine. Both divisions recognize that women with clotting disorders are at an increased risk of thrombosis during pregnancy and an increased risk of poor pregnancy outcome. Many require anticoagulation during pregnancy. Anticoagulation in pregnancy requires vigilance and anticipation of the potential bleeding complications which may occur at the time of miscarriage or childbirth. Women with bleeding disorders are also at risk of bleeding complications. Pregnant women with bleeding and clotting disorders are best served by the combined expertise of a multidisciplinary team such has been assembled at Duke.

Current staff for the Obstetric Program is:

Andra James MD– maternal-fetal medicine specialist
Leo Brancazio MD– maternal-fetal medicine specialist
Kathy Vokaty RN, PA – physician assistant from the Division of Hematology
Thomas Ortel MD, PHD – Medical Director of the Anticoagulation Clinic and back-up for the physician assistant
Laura Brown RN, NP – nurse practitioner, Raleigh office
Kristin Nunez MS– genetic counselor
Kimberlee Adcock RN – patient education and nursing support
Geraldine Wahlay – patient education and nursing support
Lynn Britt – patient education and nursing support
Melissa Britt – patient education and nursing support
Betty Thames – project coordinator for women’s hemostasis and thrombosis projects

Services are provided at weekly sessions held at the Duke Perinatal office at 2801 Erwin Road, Durham, NC, 27705. Services include:

Preconceptional counseling
Genetic counseling – not only routine, but also specific to the needs of women with inherited disorders of bleeding and clotting and women anticipating an affected child.
Obstetric ultrasound
Prenatal diagnosis
Antepartum testing
Anticoagulation monitoring
Labor, delivery and postpartum management
Sonohysterography
Collaboration and consultation with other specialties, particularly anesthesiology, neonatology, pediatric hematology, cardiology and pulmonary/critical care medicine