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- During pregnancy, hormonal influences lead to an increase in vWF and clotting factors VII, VIII, and X while anticoagulant factors (such as protein S) decrease, shifting hemostasis to a procoagulant state to compensate for anticipated hemorrhage during parturition. 3 Although vWF and FVIII levels rise and peak during the third trimester, women with vWD remain at risk of early pregnancy bleeding, as well as postpartum hemorrhage (PPH), immediate and delayed. 4 This can be explained by the rapid...
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General guidelines for the treatment of women with von Willebrand disease at delivery. Since pregnant women with VWD are at increased risk of postpartum hemorrhage if untreated 9, 17, 27, 31, treatment options should be planned at the beginning of pregnancy.
- Table 1
Given the wide heterogeneity of phenotypes and of the...
- Mcmdm-1Vwd
Introduction. von Willebrand factor (VWF) is a multimeric...
- Table 1
May 20, 2019 · Given the wide heterogeneity of phenotypes and of the underlying pathophysiological mechanisms associated with the disorder, pregnancy and delivery in von Willebrand disease (VWD) represent a significant clinical challenge. The variable pattern of changes observed during pregnancy of von Willebrand factor (VWF) and factor VIII (FVIII), the ...
- Giancarlo Castaman, Paula D. James
- 2019
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Many people with von Willebrand disease don't know it because the signs are mild or absent. The most common sign of the condition is abnormal bleeding.
There are three main types of the disease. The amount of bleeding varies from one person to another, depending on the type and severity of the disease.
If you have von Willebrand disease, you might have:
•Excessive bleeding from an injury or after surgery or dental work
•Frequent nosebleeds that don't stop within 10 minutes
•Heavy or long menstrual bleeding
Contact your doctor if you have bleeding that lasts a long time or is hard to stop.
Request an appointment
The usual cause of von Willebrand disease is an inherited abnormal gene that controls von Willebrand factor — a protein that plays a key role in blood clotting.
When you have low levels of this protein or it doesn't work as it should, small blood cells called platelets cannot stick together properly nor attach themselves normally to the blood vessel walls when an injury has occurred. This interferes with the clotting process and can sometimes cause uncontrolled bleeding.
Many people with von Willebrand disease also have low levels of factor VIII, another protein that helps in clotting.
Factor VIII is involved in another inherited clotting disorder called hemophilia. But unlike hemophilia, which mainly affects males, von Willebrand disease affects males and females and is usually milder.
The main risk factor for von Willebrand disease is having a family history of it. Parents pass the gene for the disease to their children. Rarely, the disease skips generations.
The disease is usually an "autosomal dominant inherited" disorder, which means you need a mutated gene from only one parent to get the disease. If you have the gene for von Willebrand disease, you have a 50% chance of transmitting this gene to your children.
Rarely, von Willebrand disease can cause uncontrollable bleeding, which can be life-threatening. Other complications of von Willebrand disease can include:
•Anemia. Heavy menstrual bleeding can cause iron deficiency anemia.
If you plan to have children and have a family history of von Willebrand disease, consider genetic counseling. If you carry the gene for von Willebrand disease, you can pass it on to your offspring, even if you don't have symptoms.
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By Mayo Clinic Staff
Oct 26, 2021
1.Von Willebrand disease. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/vwd/facts.html. Accessed Aug. 26, 2021.
2.AskMayoExpert. Von Willebrand disease. Mayo Clinic; 2021.
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JJ There are 3 main types of VWD. In type 1—which is the most common by far, accounting for approximately 75% of cases—the level of von Willebrand factor (VWF) is low, but the protein functions normally. In type 2, which accounts for approximately 20% of cases, the VWF level may be normal, but the protein functions abnormally. In type 3 ...
Jun 7, 2022 · Although VWD occurs equally in males and females, women are at a higher risk of being affected, mostly because of bleeding challenges associated with menstruation, pregnancy, and childbirth [ 1, 7, 8 ]. During pregnancy, many changes in hemostasis occur that result in a hypercoagulable state.
May 1, 2017 · The Case. A 37-year-old woman 28 weeks into her first pregnancy is referred to hematology clinic given a history of von Willebrand disease (vWD) diagnosed during her teenage years, after presenting with excessive menstrual bleeding requiring oral iron supplementation.
Apr 26, 2010 · Bleeding complications during pregnancy are more frequent when levels of the von Willebrand ristocetin cofactor assay and factor VIII levels are <50 IU/dL. von Willebrand disease and pregnancy: a practical approach for the diagnosis and treatment - American Journal of Obstetrics & Gynecology
