von Willebrand's disease in pregnancy

Management

• measure vWF-factor VIII & bleeding time at 36th week of gestation
• most patients with type 1 or 2 vWD do not bleed with normal vaginal delivery
• desmopressin for excessive bleeding except for type 2B
• if patient has severe type 1 disease & vWF &/or factor VIII levels are < 30% with bleeding times > 20 minutes at 36weeks of gestation, treat with vWF concentrate for several days post partum
  • MKSAP20 disagrees, asserts vWF levels should be monitored throughout pregnancy, and especially antepartum (does not explain need for monitor at 16 weeks)
• C-section
  • type 1 disease: both vWF & desmopressin may be necessary
  • type 2 & 3 disease, use only vWF concentrate

More general terms

• pregnancy disorder; obstetric disorder; pregnancy complication
• von-Willebrand's disease (vWD)