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Assessment of von Willebrand disease and pregnancy outcomes at regional Australian hospitals

journal contribution
posted on 2023-05-21, 02:19 authored by Wilson, E, Hanna, F, Hyppa, A, Orlowski, E, Dawar, HU, Sanga, Z, Dennis, A, Pavlov, T, Alhossain Khalafallah

Background: von Willebrand disease (vWD) is a heterogeneous hereditary bleeding disorder and is associated with risk of primary postpartum haemorrhage (PPH).

Design and methods: An observational study at a tertiary referral centre in Australia of 16 women with 23 deliveries with a median age of 27.5 years (range, 21-39; IQR = 9). Median gestational age at delivery was 39 weeks (range, 35-41; IQR = 1.1).

Results: All cases had type 1 vWD, apart from one case with type 2. Patients were managed in combined obstetrics and haematology clinics. PPH occurred in ten deliveries (44%). Intravenous desmopressin was administered in 6 cases, and IV human vWF was administered in 4 cases. Two cases with mild vWD had received oral tranexamic acid. The median Apgar score at 1 and 5 min was 9 (IQR = 1.0), while the median Apgar score at 10 min was 10.0 (IQR = 0.0). One case required transfusion of blood products postdelivery. There were no other significant complications observed.

Conclusions: was associated with a high incidence of primary PPH. Individualised treatment to restore haemostasis, according to the severity of the disease, could achieve as possible, normal haemostasis with favourable outcomes for both mothers and their infants. Further studies to confirm our findings are warranted.

History

Publication title

European Journal of Haematology

Volume

106

Issue

4

Pagination

456-466

ISSN

0902-4441

Department/School

Tasmanian School of Medicine

Publisher

Blackwell

Place of publication

United Kingdom

Rights statement

Copyright 2020 John Wiley & Sons A/S

Repository Status

  • Restricted

Socio-economic Objectives

Treatment of human diseases and conditions

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