Starting a family when you are affected by von Willebrand disease (VWD) presents a myriad of challenges throughout the entire process right up until labor. Women with VWD are ten times more likely to suffer a miscarriage and prepartum bleeding, as well as premature birth, stillbirth or intrauterine demise (fetal death). To lower the risk of complications during pregnancy with VWD, consider the following measures:
1. Consult a hematologist – Hematologists are doctors who specialize in bleeding disorders. Before becoming pregnant, make an appointment with both a hematologist and an obstetrician to begin planning a safe pregnancy with attention to detail and VWD management.
2. Find the right hospital – Do some research and find a medical and/or birthing center that specializes in high-risk obstetrics. These facilities typically have a resident hematologist on the premises to assist in prenatal care and delivery.
3. Approach invasive procedures with caution – One typical procedure performed during pregnancy is an amniocentesis, which is the process of drawing fluid from the pregnancy sac to test for genetic disorders and other complications pre-delivery. Speak with your doctor about measures that can be taken to prevent excessive bleeding before scheduling a procedure of this nature.
4. Get your blood tested – A good time to test your blood for von Willebrand factor and factor VIII is in the third trimester, closer to your due date. This will also help you plan accordingly.
5. Meet with your anesthesiologist – Discussing anesthesia options and medications you can take to reduce the risk of bleeding leading up to your delivery is extremely important in the planning process, as different types of these drugs have different effects on the body.
Remember, the theme here is plan and prepare. With the right approach, there is nothing holding you back from having a healthy child despite the challenge of VWD.
Sources:
Baby Center – Amniocenteses: http://www.babycenter.com/0_amniocentesis_327.bc
Journal of Thrombosis and Haemostasis – von Willebrand Disease and Pregnancy: http://www.bloodmed.com/contentimage/reviewarticles/2178.pdf
National Hemophilia Foundation – Research Update: Study Reveals Pregnancy Complications in Women with von Willebrand Disease: http://www.hemophilia.org/NHFWeb/MainPgs/MainNHF.aspx?menuid=118&contentid=925
U.S. Department of Health and Human Services – Living with von Willebrand Disease: http://www.nhlbi.nih.gov/health/dci/Diseases/vWD/vWD_LivingWith.html