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von Willebrand's disease and pregnancy: Management during delivery and outcome of offspring

  • Juan R. Chediak
    Correspondence
    Reprint requests: Juan Chediak, M.D., Division of Hematology/Oncology, Michael Reese Hospital and Medical Center, Lake Shore Dr. at 31 st St., Chicago, IL 60616.
    Affiliations
    Department of Medicine, Michael Reese Hospital and Medical Center Chicago, Illinois USA

    the University of Chicago Chicago, Illinois USA.
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  • Gladys M. Alban
    Affiliations
    Department of Medicine, Michael Reese Hospital and Medical Center Chicago, Illinois USA

    the University of Chicago Chicago, Illinois USA.
    Search for articles by this author
  • Betty Maxey
    Affiliations
    Department of Medicine, Michael Reese Hospital and Medical Center Chicago, Illinois USA

    the University of Chicago Chicago, Illinois USA.
    Search for articles by this author
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      Abstract

      Six patients having different subtypes of von Willebrand's disease were followed up during eight complete pregnancles. Two additional pregnancies terminated in spontaneous abortions. Five pregnancies ended in cesarean section either because of obstetric problems (three) or electively (two) to avoid infant bleeding. Three deliveries were complicated by vaginal bleeding attributed to von Willebrand's disease, while bleeding during two deliveries had clear obstetric causes. Only two deliveries were associated with no bleeding complications. Flve newborn babies were found to have von Willebrand's disease. One of them was born with a head hematoma. Management, which included cryoprecipitate and desmopressin (Stimate), is discussed. It is important to manage each case individually since obstetric parameters and severity of bleeding disorder must be known before treatment is planned.

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