How does von Willebrand disease (vWD) manifest in pregnancy?

Updated: Nov 30, 2019
  • Author: Perumal Thiagarajan, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Pregnant patients with this disease usually do not have problems. However, vWF and factor VIII activity fall after childbirth. In a prospective observational cohort study of 32 women with von Willebrand disease and 40 women without von Willebrand disease, vWF levels peaked at 250% of baseline at 4 hours postpartum in the von Willebrand disease group and at 12 hours postpartum in the women without von Willebrand disease and then decreased rapidly, reaching baseline at 3 weeks in both groups.

Fifteen of the women with von Willebrand disease received treatment with desmopressin or vWF concentrate before or after delivery. Except immediately postpartum, treatment did not raise vWF and factor VIII levels to normal or to the levels seen in women with milder, untreated von Willebrand disease. These researchers concluded that even with treatment, women with vWD may be at increased risk for postpartum hemorrhage. [13]

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