
Pregnancy
Von Willebrand factor and factor VIII rise during pregnancy. In many cases of von Willebrand disease, factor VIII, VWF antigen, and VWF activity will reach normal concentrations.
- Because of the increase in factor VIII levels in pregnancy, it may be difficult to exclude a diagnosis of von Willebrand’s disease in pregnancy.
- In most patients, if the factor VIII levels are going to normalise, this will occur by 34 to 36 weeks gestation.
- After delivery, the factor VIII levels fall rapidly.
- The risk of peri-delivery haemorrhage is approximately 40%. Primary postpartum haemorrhage is approximately 15 to 20%. Secondary postpartum haemorrhage is 20 ot 28%.
- It is not clear if bleeding is confined to only those women who fail to normalise factor levels in pregnancy.
Refer to Detailed management of the VWD patient in pregnancy.
Topic Code: 5280