Abstract

ESPITIA-DE LA HOZ, Franklin J. A qualitative review of the literature regarding managing Von willebrand disease in obstetrics and gynaecology. Rev Colomb Obstet Ginecol [online]. 2010, vol.61, n.2, pp.151-159. ISSN 0034-7434.

Introduction: Von Willebrand disease (vWD) is a disorder of the coagulation, being more prevalent in fertile females and is thus the most frequently occurring genetic haemostasis disorder in obstetric and gynaecological practice. Objective: reviewing the literature concerning vWD in obstetric and gynaecology patients, placing special emphasis on the disease’s physiopathology, diagnosis and treatment. Methodology: a bibliographic search was made of MEDLINE electronic databases via pubmed, Elsevier, Interscience, EBSCO, Scopus and SciELO from 1980 to 2009. The Cochrane Pregnancy and Childbirth Group (September 30th 2009) and printed texts and books were also consulted. Results: diagnosis was based on careful anamnesis and detection and confirmatory laboratory tests. Correct identification of different types and subtypes is important from a therapeutic point of view. Treatment requires specific medication such as desmopressin, factor VIII concentrates and coadjuvant therapies. No evidence was found to contraindicate vaginal birth route; however, each particular case must be taken individually. Conclusion: females suffering from coagulation disorders present a greater risk of bleeding during menarche, pregnancy, giving birth and the puerperium. This means that suitable evaluation and multidisciplinary management must be mandatory during pregnancy.

Keywords : von Willebrand disease; antifibrinolytics; tranexamic acid; epsilon aminocaproic acid; desmopressin; FVW/FVIII concentrate; obstetric and gynaecological haemorrhages.

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