Peripartum management of a parturient with type 1C (clearance) von Willebrand disease. (November 2020)

• Record Type: Journal Article
• Authors: Prior, C.; Sims, K.; Seligman, K.; Jackson, S.; Chau, A.
• Is Part Of: International journal of obstetric anesthesia. Volume 44(2020)
• Page Start: 112
• Page End: 115
• Publication Date: 2020-11
• Subjects: Type 1C -- Atypical -- Von Willebrand disease -- Anesthesia, obstetric -- Anesthesia, neuraxial -- Vicenza variant; Obstetrics -- Periodicals; Anesthesia -- Periodicals; Anesthésie en obstétrique -- Périodiques; Anesthesia; Obstetrics; Electronic journals; Periodicals; 617.9682
• DOI: 10.1016/j.ijoa.2020.08.005
• Languages: English
• ISSNs: 0959-289X

Abstract

Highlights: Type 1 von Willebrand disease usually self-corrects in pregnancy. Further workup is warranted if factor levels fail to correct by the third trimester. Type 1C is characterized by decreased plasma von Willebrand factor survival. A diagnosis of type 1C von Willebrand disease has therapeutic implications. Multidisciplinary care including a specialist bleeding disorders team is optimal. Abstract: Peripartum replacement of factor VIII and von Willebrand factor is not usually required in type 1 von Willebrand disease, as the levels of endogenous factors tend to increase to within the normal range as a physiological change of pregnancy. However, there is wide heterogeneity of genotypes and phenotypes associated with type 1 von Willebrand disease. Here, we describe the anesthetic management of a parturient with type 1C von Willebrand disease, a subtype characterized by decreased plasma von Willebrand factor survival.