• Blood reviews · Jan 2020

    Maternal and neonatal bleeding complications in relation to peripartum management in women with Von Willebrand disease: A systematic review.

    • M C Punt, M L Waning, E P Mauser-Bunschoten, KruipM J H AMJHADoctor Molewaterplein 40, 3015 GD Rotterdam, Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: m.kruip@erasmusmc.nl., J Eikenboom, L Nieuwenhuizen, A B U Makelburg, M H E Driessens, J J Duvekot, M Peters, J M Middeldorp, BloemenkampK W MKWMHeidelberglaan 100, 3584 CX Utrecht, Department of Gynaecology and Obstetrics, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: K.W.M.Bloemenkamp@umcutrecht.nl., SchutgensR E GREGHeidelberglaan 100, 3584 CX Utrecht, Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands. Electronic address: R.Schutgens@umcutrecht.nl., A T Lely, and K P M Van Galen.
    • Heidelberglaan 100, 3584 CX Utrecht, Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands. Electronic address: m.c.punt-3@umcutrecht.nl.
    • Blood Rev. 2020 Jan 1; 39: 100633.

    AbstractWomen with Von Willebrand disease (VWD) have an increased risk of developing postpartum hemorrhage (PPH). Our aim is to evaluate peripartum management strategies in relation to maternal and neonatal bleeding complications in VWD. Electronic databases were searched up to January 2019. Seventy-one case-reports and -series and 16 cohort studies were selected, including 811 deliveries. Cohort studies reported primary PPH in 32% and secondary PPH in 13% of the women. The overall primary PPH incidence in the individual patient data was 34%, similar between women who received prophylactic treatment to prevent PPH and those who didn't. Neonatal bleeding events were reported in 4.6% of deliveries. Overall, the available evidence on peripartum management in women with VWD was of low quality. The ongoing high risk for PPH is evident, despite prophylactic treatment, as well as the need for higher quality evidence from larger prospective cohort studies to improve management strategies.Copyright © 2019 Elsevier Ltd. All rights reserved.

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