Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
For a pregnant patient with a known history of von Willebrand disease, the recommended management strategies include:
- Plan birth in an obstetric-led unit with access to a neonatal unit capable of high-dependency care to manage potential bleeding risks for both mother and baby.
- Active management of the third stage of labour is advised rather than physiological management to reduce the risk of postpartum haemorrhage.
- Avoid intramuscular injections of uterotonics to minimise bleeding risk.
- Individualised postpartum care should be arranged in consultation with a senior haematologist, including measurement of blood loss, monitoring for obstetric complications, and haematological parameters.
- Inform the woman about the risk of secondary postpartum bleeding and how to access care after discharge.
- Be cautious with the use of non-steroidal anti-inflammatory drugs as they can increase bleeding risk.
These strategies aim to reduce bleeding complications associated with von Willebrand disease during pregnancy, labour, and postpartum.