Von Willebrand's disease and pregnancy

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Maternal-Fetal Medicine

Background:

• Von Willebrand disease (VWD) is a common inherited bleeding disorder.
• Pregnancy in women with VWD requires careful management due to increased bleeding risks.
• Factor VIII therapy is often considered to prevent postpartum hemorrhage.

Observation:

• This case describes a pregnant patient with VWD undergoing cesarean section.
• The patient had a persistently prolonged bleeding time throughout her pregnancy.
• Cesarean delivery was performed without the administration of supportive Factor VIII therapy.

Findings:

• The patient experienced no significant postoperative bleeding.
• Bleeding time, Factor VIII activity, and Factor VIII-related antigen levels were monitored.
• These parameters were evaluated in relation to the patient's bleeding tendency and management.

Implications:

• This case suggests that cesarean delivery in select VWD patients may be managed without prophylactic Factor VIII.
• Careful monitoring of hemostatic markers is crucial for assessing bleeding risk in pregnant VWD patients.
• Further research may refine therapeutic strategies for VWD management during pregnancy and delivery.