[Delivery complications and perinatal results in pregnant women with von Willebrand disease].
OBJECTIVE
To study maternal complication associated to delivery and the puerperium period in pregnancies affected by von Willebrand's disease.


METHODS
Chart data of all the pregnant women with diagnosis of von Willebrand disease were retrospectively reviewed. All cases with von Willebrand's disease that had given birth at this institution, between March 2001 and August 2007, were analyzed. The following variables were investigated: mode of delivery, hemorrhage complications during delivery and postpartum, maternal blood exams and perinatal results. Variables were studied descriptively, using absolute and relative frequencies, means, medians and standard deviations.


RESULTS
13 pregnancies of eight women with the disease were reviewed. During this sane period, there were 13,037 deliveries in the institution, resulting in an incidence of 0.1%. Six women (75%) were type 1 disease and, two (25%) were type 2. The last Factor VIIIc activity presented a mean value of 98.5%. A Cesarean section was performed in nine pregnancies, with epidural anesthesia in seven. Delivery complication occurred in two cases: one presented placental abruption and a Cesarean was performed. The other, presented postpartum hemorrhage in the first day and required reposition with factor VIII. Two cases received factor VIII before Cesarean section. Fetal growth restriction was detected in five pregnancies (38.5%). Mean birth weight was of 2676 grams and one case presented 1st minute Apgar score below seven.


CONCLUSIONS
Delivery in patients with von Willebrand disease has a favorable evolution when specific assistance is provided. In these pregnancies,fetal growth should be monitored.
Nomura
Roseli Mieko Yamamoto
RM
Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP. roseli.nomura@terra.com.br
Igai
Ana Maria Kondo
AM
Zugaib
Marcelo
M
D001034:Apgar Score; D001724:Birth Weight / Q000502:physiology; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D005169:Factor VIII / Q000008:administration & dosage / Q000032:analysis; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000097:blood*; D006473:Postpartum Hemorrhage / Q000097:blood*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood*; D011256:Pregnancy Outcome; D055815:Young Adult; D014842:von Willebrand Diseases / Q000097:blood / Q000150:complications*
D005169:Factor VIII