Document Detail


von Willebrand disease, pregnancy and neuraxial anesthesia: a multi-disciplinary approach for successful regional anesthesia.
MedLine Citation:
PMID:  19475813     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fearing the devastating neurological complications in a parturient with the von Willebrand disease secondary to paucity of studies defining the guidelines to assess the risk of bleeding complications, anesthesiologists are often reluctant to administer neuroaxial anesthesia. We present a case report of a parturient with type I von Willebrand disease who presented for induction of labor at 39 weeks of gestation. After consultation with the hematologist well ahead of the conception, appropriate laboratory workup including clotting factor levels including FVIII, vWF:RcoF, vWF:Ag on different occasions peripartum, and provision of adequate prophylactic medical treatment, she underwent Cesarean section under epidural anesthesia without neurological or bleeding complications. von Willebrand disease is the most common inherited bleeding disorder that may result in various bleeding complications in a parturient as a result of hemostatic challenges during pregnancy. Yet the recommendations are based on anecdotal observations of the authors of small case series and surveys. Our case report emphasizes the importance of advanced planning, careful patient assessment, and multi-disciplinary team approach for the successful regional anesthesia as suggested by the guidelines based on clinical experiences.
Authors:
F Kailash; D Wilkerson
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of the Arkansas Medical Society     Volume:  105     ISSN:  0004-1858     ISO Abbreviation:  J Ark Med Soc     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-29     Completed Date:  2009-06-26     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  7503069     Medline TA:  J Ark Med Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  259-60, 262     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Epidural*
Anesthesia, Obstetrical*
Cesarean Section*
Deamino Arginine Vasopressin / administration & dosage
Factor VIII / administration & dosage
Female
Hemorrhage / prevention & control
Hemostatics / administration & dosage
Humans
Pregnancy
Pregnancy Complications, Hematologic*
von Willebrand Diseases / drug therapy*
Chemical
Reg. No./Substance:
0/Hemostatics; 16679-58-6/Deamino Arginine Vasopressin; 9001-27-8/Factor VIII

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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