Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
Von Willebrand Disease in Pregnancy | | | QUESTION | | | Dear Dr. Greenfield,
I have von Willebrand. How will this affect my delivery? This is my first child.— Tisha in Arkansas | | | ANSWER |
September 27, 2001 | | | Dear Tisha,
As you know, von Willebrand Disease (vWD) is an inherited disorder of a clotting factor that affects platelets; it interferes with the blood's ability to clot. About one percent of Americans have vWD. There are several subtypes of this disorder that have somewhat different risks and require different treatment in pregnancy.
Most women with vWD experience some improvement in their condition during gestation, since the hormones of pregnancy increase many clotting factors. As for childbirth, the bleeding that occurs after the placenta is expelled is normally controlled by uterine contractions, which squeeze the blood vessels and stop the blood from flowing out of the uterus. This mechanism is fully functional in women with clotting disorders. There are times though that vWD does lead to hemorrhaging at childbirth, either immediately while in the delivery room, or at a later time within the next few weeks. Since there are different types of vWD, which respond to different treatments, your hematologist should advise your obstetrician about what to do if you have excess bleeding at birth. Sometimes in severe vWD, medications are given preventatively during labor. Since vWD is hereditary, it also is important to make sure your pediatrician knows about your condition and assesses your baby after delivery.
While you need to be aware of potential complications, it's generally considered safe to get pregnant with von Willebrand Disease, and most women do quite well through pregnancy and childbirth. Again, I think you should talk to your OB and your hematologist about your own particular situation. Good luck!— by Marjorie Greenfield, M.D. |
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