Postpartum bleeding and von Willebrand's disease

We calculated the decreases in hemoglobin levels between the day of delivery and postpartum day 3 in all 3565 deliveries of the year 1997. Fourteen patients had a drop in hemoglobin level of more than 8% and were included in the study. Ten women without excessive bleeding served as a control group....

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Bibliographic Details
Published in:Archives of gynecology and obstetrics 2002-07, Vol.266 (3), p.160-162
Main Authors: Hundegger, R, Husslein, P, Berghammer, P, Egarter, C, Kyrle, A
Format: Article
Language:English
Subjects:
Adult
Antigens - blood
Factor VIII - analysis
Female
Health risk assessment
Hemoglobin
Hemoglobins - analysis
Humans
Incidence
Postpartum Hemorrhage - blood
Postpartum Hemorrhage - diagnosis
Postpartum Hemorrhage - etiology
Retrospective Studies
von Willebrand Diseases - blood
von Willebrand Diseases - complications
von Willebrand Diseases - diagnosis
von Willebrand Diseases - epidemiology
von Willebrand Factor - immunology
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Summary:We calculated the decreases in hemoglobin levels between the day of delivery and postpartum day 3 in all 3565 deliveries of the year 1997. Fourteen patients had a drop in hemoglobin level of more than 8% and were included in the study. Ten women without excessive bleeding served as a control group. In all women tested, plasma von willebrand factor antigen (vWF:Ag) correlated well with factor VIII:C activity, and both were within normal limits, so that we were able to exclude the presence of type I von willebrand's disease (vWD I). Two women in the excessive bleeding group were found to have an isolated decrease in coagulation factor activity. In one patient, factor XI:C and XII:C activities were reduced to 46% and 53% respectively, and APTT was prolonged to 48.5 seconds. In the other, factor VII:C activity had dropped to 69%, and Normotest results were only 62%. Ten of the 14 patients and 1 woman of the control group were diagnosed as having mild anemia. We conclude that investigations for vWD I should only be done in women with a previous history of abnormal bleeding.
ISSN:0932-0067
1432-0711
DOI:10.1007/s004040100220