Postpartum bleeding and von Willebrand's disease.
We calculated the decreases in hemoglobin levels between the day of delivery and postpartum day 3 in all 3565 deliveries of the year 1997. Fourteen patients had a drop in hemoglobin level of more than 8% and were included in the study. Ten women without excessive bleeding served as a control group. In all women tested, plasma von willebrand factor antigen (vWF:Ag) correlated well with factor VIII:C activity, and both were within normal limits, so that we were able to exclude the presence of type I von willebrand's disease (vWD I). Two women in the excessive bleeding group were found to have an isolated decrease in coagulation factor activity. In one patient, factor XI:C and XII:C activities were reduced to 46% and 53% respectively, and APTT was prolonged to 48.5 seconds. In the other, factor VII:C activity had dropped to 69%, and Normotest results were only 62%. Ten of the 14 patients and 1 woman of the control group were diagnosed as having mild anemia. We conclude that investigations for vWD I should only be done in women with a previous history of abnormal bleeding.
Department of Obstetrics and Gynecology, University of Vienna Medical School.
R
R
Hundegger
P
P
Husslein
P
P
Berghammer
C
C
Egarter
A
A
Kyrle
D000328:Adult; D000941:Antigens / Q000097:blood; D005169:Factor VIII / Q000032:analysis; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015994:Incidence; D006473:Postpartum Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D014842:von Willebrand Diseases / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D014841:von Willebrand Factor / Q000276:immunology
D000941:Antigens; D006454:Hemoglobins; C029417:Von Willebrand antigen; D014841:von Willebrand Factor; D005169:Factor VIII