| von Willebrand disease and pregnancy: a practical approach for the diagnosis and treatment. | |
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MedLine Citation:
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PMID: 20417473 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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von Willebrand disease is caused by either a quantitative or qualitative defect in von Willebrand factor (VWF). Patients may have extensive mucosal bleeding (because of platelet dysfunction) and prolonged bleeding after surgery (because of factor VIII deficiency). Up to 6 different subtypes of the disease have been described, and diagnosis is based on clinical suspicion and laboratory confirmation. Accurate diagnosis is of paramount importance because therapy will vary according to the subtype. Bleeding complications during pregnancy are more frequent when levels of the von Willebrand ristocetin cofactor assay and factor VIII levels are <50 IU/dL. In such cases, therapy before any invasive procedure or delivery must be instituted. The mainstays of therapy are desmopressin and plasma concentrates that contain von Willebrand factor. Delayed postpartum hemorrhage may occur, despite adequate prophylaxis. Frequent monitoring and continued prophylaxis and/or treatment are recommended for at least 2 weeks after delivery. |
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Authors:
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Luis D Pacheco; Maged M Costantine; George R Saade; Sara Mucowski; Gary D V Hankins; Anthony C Sciscione |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-04-24 |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 203 ISSN: 1097-6868 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-06 Completed Date: 2010-09-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 194-200 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 Mosby, Inc. All rights reserved. |
Affiliation:
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Divisions of Maternal Fetal Medicine and Surgical Critical Care, Departments of Obstetrics & Gynecology and Anesthesiology, The University of Texas Medical Branch, Galveston, TX, USA. ldpachec@utmb.edu |
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Component Transfusion Chromosomes, Human, Pair 12 Continuity of Patient Care Deamino Arginine Vasopressin / therapeutic use Delivery, Obstetric Factor VIII / therapeutic use Female Hemostatics / therapeutic use Humans Mutation Postpartum Hemorrhage / prevention & control Postpartum Period Pregnancy Pregnancy Complications, Hematologic / diagnosis*, therapy* Ristocetin / diagnostic use Uterine Hemorrhage / prevention & control von Willebrand Diseases / classification, diagnosis*, genetics, therapy* von Willebrand Factor / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Hemostatics; 0/von Willebrand Factor; 1404-55-3/Ristocetin; 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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