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Von Willebrand disease is a prevalent condition in females of childbearing age, and during pregnancy, it is associated with a higher risk of postpartum bleeding, exposure to massive transfusion protocols, pulmonary edema, acute renal injury, postpartum bleeding-related maternal mortality, and transfusion-related complications .
In the pregnant patient, Von Willebrand disease poses an increased risk of complications during labor or the postpartum period, attributed to a higher likelihood of experiencing postpartum hemorrhage and its consequential complications arising from transfusion support and multiorgan injury due to tissue hypoperfusion.
Bleeding complications during pregnancy are more frequent when levels of the von Willebrand ristocetin cofactor assay and factor VIII levels are 50 IU/dL. In such cases, therapy before any invasive procedure or delivery must be instituted. The mainstays of therapy are desmopressin and plasma concentrates that contain von Willebrand factor.
Feb 2, 2024 · Von Willebrand Disease and Pregnancy: Management Protocol From Labor to the Postpartum Period. Brandon Alejandro Muñoz Vargas • Silvia Juliana Contreras Valero • Rafael Leonardo Aragon Mendoza • Roberto Gallo Roa • Leonardo Jose Enciso Olivera. Published: February 02, 2024. DOI: 10.7759/cureus.53465. Peer-Reviewed.
Major therapies include use of desmopressin to induce endothelial release of stored von Willebrand factor (VWF) and factor VIII (FVIII) and use of VWF concentrates, including both plasma-derived and recombinant products, as well as adjuvant therapies, such as antifibrinolytic tranexamic acid.
Feb 1, 2024 · Leonardo Jose Enciso Olivera. Published in Cureus 1 February 2024. Medicine. TLDR. The case of a 25-year-old G3P2V2A1 patient with a preexisting diagnosis of Von Willebrand disease prior to gestation, underscores the significance of specialized management for Von Willebrand disease during pregnancy and childbirth, emphasizing adherence to ...
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Furthermore, changes that can occur naturally in the coagulation system during pregnancy may complicate diagnosis and treatment. This case report illustrates the management of a pregnant woman presenting to labor and delivery with a history of easy and frequent bleeding.
