Targeting a higher plasma VWF level at time of delivery in pregnant individuals with von Willebrand disease: Outcomes at a single-institution cohort study.
Haemophilia
; 30(2): 470-477, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-38343098
ABSTRACT
INTRODUCTION:
Guidelines on the management of pregnant individuals with von Willebrand disease (VWD) at the time of delivery recommend that von Willebrand factor (VWF) and factor VIIIC (FVIIIC) levels be ≥50% to prevent postpartum haemorrhage (PPH). Yet, high PPH rates persist despite these levels or with prophylactic factor replacement therapy to achieve these levels.AIMS:
The current practice at our centre has been to target peak plasma VWF and FVIIIC levels of ≥100 IU/dL at time of delivery. The objective of this study was to describe obstetric outcomes in pregnant individuals with VWD who were managed at our centre.METHODS:
Demographics and outcomes on pregnant individuals with VWD who delivered between January 2015 and April 2023 were collected.RESULTS:
Forty-seven singleton deliveries (among 41 individuals) resulting in 46 live births and one foetal death were included. Twenty-one individuals had at least one prior birth by the start date of this study, of which 11 (52.4%) self-reported a history of PPH. Early PPH occurred in 12.8% (6/47) of deliveries. Two individuals required blood transfusion, of which one also had an unplanned hysterectomy and transfer to ICU. There were no thrombotic events reported.CONCLUSION:
The strategy of targeting higher peak plasma VWF and FVIIIC levels (≥100 IU/dL) at the time of delivery may be effective in reducing the risk of delivery-associated bleeding complications in VWD patients. Yet, the rate of early PPH remains unsatisfactory compared to the non-VWD population.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças de von Willebrand
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Hemostáticos
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Hemorragia Pós-Parto
Tipo de estudo:
Etiology_studies
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Guideline
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Pregnancy
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article