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POSTPARTUM HEMORRHAGE IN WOMEN WITH VON WILLEBRAND DISEASE - A RETROSPECTIVE OBSERVATIONAL STUDY
Author(s): ,
Igor Govorov
Affiliations:
Karolinska Institutet, SWEDEN
,
S Löfgren
Affiliations:
Karolinska Institutet, SWEDEN
,
R Chaireti
Affiliations:
Karolinska Institutet, SWEDEN
,
K Bremme
Affiliations:
Karolinska Institutet, SWEDEN
,
M Holmström
Affiliations:
Karolinska Institutet, SWEDEN
M Mints
Affiliations:
Karolinska Institutet, SWEDEN
EHA Library. Govorov I. 09/16/16; 145380; P05 Disclosure(s): Karolinska Institutet, SWEDEN
Igor Govorov
Igor Govorov
Contributions
Abstract

Abstract: P05

Type: Poster presentation

Presentation during EHA Scientific Conference on Bleeding Disorders:
On Friday, September 16, 2016 from 14:00 - 15:30

Location: Cristal + Coral

Introduction
Von Willebrand disease (VWD) is a hereditary bleeding disorder, caused by a deficiency in the levels and/or function of von Willebrand factor (VWF). Women with VWD appear to be at increased risk of experiencing postpartum hemorrhage (PPH), though the levels of VWF increase during pregnancy. There is limited knowledge of how PPH is associated with the subtype of VWD, plasma levels of other coagulations factors than VWF and given hemostatic treatment.

Aims
The aims were to investigate the incidence of PPH in women with VWD and to analyse the correlation between PPH and: (1) type of VWD, (2) laboratory monitoring of VWF and FVIII and (3) hemostatic drug treatment.

Methods
This was a retrospective observational study. The study participants (n=34) were recruited from the Coagulation Unit, Karolinska University hospital. Fifty-nine deliveries occurred in 14 different obstetrics units (years 1995-2012) were included in the study.

Results
The incidence of primary PPH was 44%, severe primary PPH 20% and secondary PPH 12%. VWD type 3 was associated with a higher risk of experiencing severe primary PPH compared to other subtypes. FVIII:C in pregnancy was inversely correlated to blood loss during delivery. There was a significantly higher incidence of secondary PPH when the VWD diagnosis was unknown at time of delivery.

Conclusions
The women with VWD are at higher risk of PPH, especially those with type 3 VWD or when diagnosis is unknown prior to delivery. Identification of pregnant women with undiagnosed VWD may be of importance in order to prevent PPH.

Abstract: P05

Type: Poster presentation

Presentation during EHA Scientific Conference on Bleeding Disorders:
On Friday, September 16, 2016 from 14:00 - 15:30

Location: Cristal + Coral

Introduction
Von Willebrand disease (VWD) is a hereditary bleeding disorder, caused by a deficiency in the levels and/or function of von Willebrand factor (VWF). Women with VWD appear to be at increased risk of experiencing postpartum hemorrhage (PPH), though the levels of VWF increase during pregnancy. There is limited knowledge of how PPH is associated with the subtype of VWD, plasma levels of other coagulations factors than VWF and given hemostatic treatment.

Aims
The aims were to investigate the incidence of PPH in women with VWD and to analyse the correlation between PPH and: (1) type of VWD, (2) laboratory monitoring of VWF and FVIII and (3) hemostatic drug treatment.

Methods
This was a retrospective observational study. The study participants (n=34) were recruited from the Coagulation Unit, Karolinska University hospital. Fifty-nine deliveries occurred in 14 different obstetrics units (years 1995-2012) were included in the study.

Results
The incidence of primary PPH was 44%, severe primary PPH 20% and secondary PPH 12%. VWD type 3 was associated with a higher risk of experiencing severe primary PPH compared to other subtypes. FVIII:C in pregnancy was inversely correlated to blood loss during delivery. There was a significantly higher incidence of secondary PPH when the VWD diagnosis was unknown at time of delivery.

Conclusions
The women with VWD are at higher risk of PPH, especially those with type 3 VWD or when diagnosis is unknown prior to delivery. Identification of pregnant women with undiagnosed VWD may be of importance in order to prevent PPH.

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