Menorrhagia and postpartum haemorrhage in women with rare bleeding disorder

In women, von Willebrand disease (VWD) is the most common inherited bleeding disorder. Objectively, it is defined as bleeding that lasts for more than seven days or results in the loss of more than 80 mL of blood per menstrual cycle. The prevalence of menorrhagia in a woman with a bleeding disorder ranges from 32 to 100%. Postpartum hemorrhage (PPH) remains one of the leading causes of maternal morbidity and mortality worldwide. A treatment algorithm for severe persistent PPH was subsequently developed. These include mechanical or surgical maneuvers, i.e., intrauterine balloon tamponade or hemostatic brace sutures with hysterectomy as the final surgical option for uncontrollable PPH. Pharmacologic options include hemostatic agents (tranexamic acid), with timely transfusion of blood and plasma products playing an important role in persistent and severe PPH.