Women with VWD Risk Postpartum Hemorrhage
Horizons in Hemophilia, August 2012
Submitted by the National Hemophilia Foundation
Results from a new study suggest that current postpartum strategies do not adequately boost von Willebrand factor (VWF) levels, contributing to potential postpartum hemorrhage in women with von Willebrand disease (VWD). Current strategies do not increase VWF levels to the normal range or even to levels of women with milder, untreated VWD. The principal investigator of the study was Andra James, MD, Professor of Obstetrics and Gynecology at the University of Virginia in Richmond. James, who was lead investigator while still at Duke University, presented early study findings at the World Federation of Hemophilia’s 2012 World Congress, July 9-12th in Paris, France.
The study, supported by a $1.2 million unrestricted grant from CSL Behring, was designed to compare changes in blood levels of VWF proteins postpartum between 31 women with and 40 women without VWD. Of the 14 women with VWD who were treated during the postpartum period, 12 were given VWF concentrate, one was given the synthetic hormone desmopressin plus VWF concentrate and one was treated with desmopressin alone.
In healthy women, VWF levels fell rapidly after childbirth, approached baseline one week postpartum and reached baseline three weeks postpartum. The pattern of decrease in these levels was consistent among all patient groups, but levels were significantly lower in women with VWD. VWF levels were lowest among treated VWD patients.
“While a rapid decrease in VWF levels after delivery is normal, significant decreases following childbirth can result in an increased risk for postpartum hemorrhage, especially since women continue to bleed for days to weeks after delivery,” said James “Given that current postpartum treatment strategies do not effectively manage VWF levels in the VWD patient, we hope to conduct further study into the benefits of prophylaxis treatment for preventing the potentially serious complication of delayed postpartum.”
Source: PRNewswire, July 11, 2012