von Willebrand's disease and pregnancy: management during delivery and outcome of offspring.
Six patients having different subtypes of von Willebrand's disease were followed up during eight complete pregnancies. Two additional pregnancies terminated in spontaneous abortions. Five pregnancies ended in cesarean section either because of obstetric problems (three) or electively (two) to avoid infant bleeding. Three deliveries were complicated by vaginal bleeding attributed to von Willebrand's disease, while bleeding during two deliveries had clear obstetric causes. Only two deliveries were associated with no bleeding complications. Five newborn babies were found to have von Willebrand's disease. One of them was born with a head hematoma. Management, which included cryoprecipitate and desmopressin (Stimate), is discussed. It is important to manage each case individually since obstetric parameters and severity of bleeding disorder must be known before treatment is planned.
D000293:Adolescent; D000328:Adult; D000941:Antigens; D001780:Blood Coagulation Tests; D003894:Deamino Arginine Vasopressin / Q000009:adverse effects / Q000627:therapeutic use; D036861:Delivery, Obstetric; D005169:Factor VIII / Q000627:therapeutic use; D005260:Female; D005312:Fetal Blood; D005340:Fibrinogen / Q000627:therapeutic use; D005817:Genetic Counseling; D006801:Humans; D007231:Infant, Newborn; D010500:Perinatology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000628:therapy*; D011644:Puerperal Disorders / Q000628:therapy; D014592:Uterine Hemorrhage / Q000150:complications; D014842:von Willebrand Diseases / Q000097:blood / Q000628:therapy*; D014841:von Willebrand Factor / Q000032:analysis
D000941:Antigens; C029417:Von Willebrand antigen; C026912:cryoprecipitate coagulum; D014841:von Willebrand Factor; D005169:Factor VIII; D005340:Fibrinogen; D003894:Deamino Arginine Vasopressin