Ukrainian Journal of Perinatology and Pediatrics. 2024. 2(98): 122-127; doi: 10.15574/PP.2024.98.122
Нrek L. P.¹, Dubossarska Y. O.¹, Puzii O. M.², Shevchenko Z. V.^2
1Dnipro State Medical University, Ukraine
²Municipal company «Regional Medical Center of Family Health» of the Dnipropetrovsk Regional Council, Dnipro, Ukraine

For citation: Нrek LP, Dubossarska YO, Puzii OM, Shevchenko ZV. (2024). Features of pregnancy and delivery management in a woman with Willebrand's disease: a case report. Ukrainian Journal of Perinatology and Pediatrics. 2(98): 122-127; doi: 10.15574/PP.2024.98.122.
Article received: Mar 01, 2024. Accepted for publication: Jun 15, 2024.

Von Willebrand disease (VWD) is a serious medical problem. Women with VWD have a 1,5-fold increased risk of postpartum bleeding, the frequency of which ranges from 40% to 60%.
Аim – to analyse the features of prevention of obstetric bleeding in women with VWD on the basis of a clinical case.
The fluctuating nature of von Willebrand factor (VWF) and factor VIII during pregnancy prompts a thorough examination of pregnant women with VWD by a multidisciplinary team involving an obstetrician-gynaecologist, haematologist, anaesthetist and other specialists at a health care facility of the third level of perinatal care for the most appropriate treatment during delivery and in the postpartum period. When planning a delivery, it is advisable to prepare a sufficient amount of blood products and hemostatic drugs. Women with VWD have an increased risk of postpartum bleeding, and the volume and composition of infusion and transfusion therapy depends on the amount of blood loss. Prevention of both early and late postpartum bleeding requires medical therapy with uterotonic agents, factor VIII and VWF release inducers, antifibrinolytics, along with transfusion therapy, which helps to normalise coagulation hemostasis and restore the general condition of the postpartum woman. Infusion and transfusion therapy, haemostatic therapy with tranexamic acid, and a qualified technique for performing surgical delivery by caesarean section using argon-plasma coagulation for haemostasis allowed preserving the fertility of a woman with VWD with obstetric coagulopathic bleeding.
The study was performed in accordance with the main provisions of the Helsinki Declaration, and the patient's consent was obtained.
The authors declare no conflict of interest.
Keywords: von Willebrand disease, infusion and transfusion therapy, postpartum haemorrhage, coagulopathy.

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