Von Willebrand disease in pregnancy: a case report

Authors

  • Rashmi A. G. Department of Obstetrics and Gynecology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • Riya Kumar Department of Obstetrics and Gynecology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India http://orcid.org/0000-0001-7329-3754
  • Dayamayi A. S. Department of Obstetrics and Gynecology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • Spandana Nallapilli Department of Obstetrics and Gynecology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20214673

Keywords:

Von Willebrand disease, Pregnancy, Postpartum hemorrhage, Bleeding disorder, Blood products

Abstract

Von Willebrand disease (VWD) is a hereditary bleeding disorder that can be severe and potentially life-threatening, particularly in pregnant women during labor and subsequently during early puerperium. There is no optimal treatment or management for this disorder. Hence, all efforts aim at early diagnosis and the focus is mainly on minimising and controlling blood loss. We described the case of a woman in the post-partum period with severe VWD, admitted in the obstetrics and gynaecology ward at Rajarajeswari Medical College and Hospital, Bangalore. Prompt diagnosis, initiation of pre-partum and intra-partum Von Willebrand factor (VWF)/clotting factor replacement therapy, vigilant post-partum monitoring of blood loss and systematic follow up will help expedite recovery and prevent adverse outcomes.

References

Inocêncio G, Braga A, Azevedo S, Buchner G. Management of von Willebrand disease type 3 during pregnancy - 2 cases reports. Eur Rev Med Pharmacol Sci. 2013;17(21):2857-9.

National Library of Medicine. Von Willebrand disease: MedlinePlus Medical Encyclopedia, 2012. Available at: https://medlineplus.gov/genetics/condition/vonwillebrand-disease/. Accessed on 07 October 2021.

Kujovich JL. von Willebrand disease and pregnancy. J Thromb Haemost. 2005;3(2):246-53.

Nichols WL, Rick ME, Ortel TL, Montgomery RR, Sadler JE, Yawn BP, et al. Clinical and laboratory diagnosis of von Willebrand disease: a synopsis of the 2008 NHLBI/NIH guidelines. Am J Hematol. 2009;84(6):366-70.

Goodeve A, James P. von Willebrand Disease. In: Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Mirzaa G, et al, eds. GeneReviews®. Seattle, WA: University of Washington, Seattle; 2009: 1993-2021.

Sadler JE, Budde U, Eikenboom JC, Favaloro EJ, Hill FG, Holmberg L, et al. Update on the pathophysiology and classification of von Willebrand disease: a report of the Subcommittee on von Willebrand Factor. J Thromb Haemost. 2006;4(10):2103-14.

National Haemophilia Foundation. National Haemophilia Foundation for all bleeding disorders, 2021. Available at: https://www.hemophilia.org/. Accessed on 07 October 2021.

Molecular basis of von Willebrand disease and its clinical implications. Haematologica. 2004;89(9):1036.

Lilicarp D, Jams P. Von Willebrand disease: an introduction for the primary care physician. Canada: World Federation of Hemophilia; 2009.

Pacheco LD, Costantine MM, Saade GR, Mucowski S, Hankins GD, Sciscione AC. von Willebrand disease and pregnancy: a practical approach for the diagnosis and treatment. Am J Obstet Gynecol. 2010;203(3):194-200.

Conti M, Mari D, Conti E, Muggiasca ML, Mannucci PM. Pregnancy in women with different types of von Willebrand disease. Obstet Gynecol. 1986;68(2):282-5.

Echahdi H, Hasbaoui B, Khorassani M, Agadr A, Khattab M. Von Willebrand's disease: case report and review of literature. Pan Afr Med J. 2017;27:147.

Kujovich JL. von Willebrand disease and pregnancy. J Thromb Haemost. 2005;3(2):246-53.

Sadler JE, Mannucci PM, Berntorp E, Bochkov N, Boulyjenkov V, Ginsburg D, et al. Impact, diagnosis and treatment of von Willebrand disease. Thromb Haemost. 2000;84(2):160-74.

Sié P, Caron C, Azam J, Goudemand J, Grandjean H, Boneu B, et al. Reassessment of von Willebrand factor (VWF), VWF propeptide, factor VIII:C and plasminogen activator inhibitors 1 and 2 during normal pregnancy. Br J Haematol. 2003;121(6):897-903.

Clark P, Brennand J, Conkie JA, McCall F, Greer IA, Walker ID. Activated protein C sensitivity, protein C, protein S and coagulation in normal pregnancy. Thromb Haemost. 1998;79(6):1166-70.

Kadir RA, Lee CA, Sabin CA, Pollard D, Economides DL. Pregnancy in women with von Willebrand's disease or factor XI deficiency. Br J Obstet Gynaecol. 1998;105(3):314-21.

Chediak JR, Alban GM, Maxey B. von Willebrand's disease and pregnancy: management during delivery and outcome of offspring. Am J Obstet Gynecol. 1986;155(3):618-24.

Hanna W, McCarroll D, McDonald T, Painter P, Tuller J, Chen J, Lange R. Variant von Willebrand's disease and pregnancy. Blood. 1981;58(5):873-9.

Ramsahoye BH, Davies SV, Dasani H, Pearson JF. Obstetric management in von Willebrand's disease: a report of 24 pregnancies and a reivesw of the literature. Haemophilia. 1995;1(2):140-4.

Ragni MV, Bontempo FA, Hassett AC. von Willebrand disease and bleeding in women. Haemophilia. 1999;5(5):313-7.

Kadir RA, Lee CA, Sabin CA, Pollard D, Economides DL. Pregnancy in women with von Willebrand's disease or factor XI deficiency. Br J Obstet Gynaecol. 1998;105(3):314-21.

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Published

2021-11-25

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Section

Case Reports