Von Willebrand's disease and pregnancy

Seven new cases of pregnancy combined with von Willebrand's disease have been reported. Altogether the patients had 11 deliveries, and one abortion after 10 weeks' gestation. The diagnosis was based on the determination of the bleeding time, factor VIII coagulant activity (VIII C), factor VIII-related antigen (VIII RAg) and the ristocetin cofactor (VIII RCoF). Two of our 6 parturients showed profuse bleeding at delivery; in addition one patient showed bleeding after abortion at 10 weeks' gestation. Vaginal delivery is generally safe in patients with von Willebrand's disease. There is a great risk of copious bleeding especially in connection with early abortion, when factor VIII levels are low.