Can von Willebrand disease affect pregnancy?

Von Willebrand disease puts you at a higher risk of bleeding during pregnancy and after childbirth. The main concern is managing maternal bleeding to ensure a safe pregnancy and delivery.

How do you treat von Willebrand disease?

Unfortunately, there is no cure for von Willebrand disease, but you can manage it. Your doctor may suggest medications to stop or prevent excessive bleeding or infusions of Willebrand factor. Infusions involve receiving the missing clotting protein directly into your bloodstream through a vein, helping your blood to clot properly during bleeding episodes or before surgery.

Who is at risk for von Willebrand disease?

Von Willebrand disease can be inherited in different ways depending on the type. Some forms are passed down from one affected parent (autosomal dominant), while others require both parents to carry the gene (autosomal recessive).

Von Willebrand Disease & Pregnancy: What You Must Know

If you have experienced unusually long bleeding episodes in the past, then you may be susceptible to von Willebrand disease (vWD). This genetic bleeding disorder prevents the formation of clots in your blood. It means you bleed longer, even with minor cuts or injuries.

Generally, your parents may pass it on, and you may have it for years without awareness. Frequent nosebleeds and heavy menstrual bleeding are some of the common signs that indicate vWD.

Although vWD is manageable, the chances of complications increase when you are pregnant. Even minor events can cause significant risks to you and your baby. However, you can have a healthy pregnancy and delivery with the right medical support.

What Is Von Willebrand Disease?

Von Willebrand disease is a genetic blood disorder that prevents the formation of blood clots necessary to stop bleeding. A blood clot is made up of many types of protein, and von Willebrand Factor (vWF) is one of them.

Your chances of vWD increase when you have lower vWF levels in your blood or when it does not work properly.

When you bleed, the vWF in the blood attaches to the platelets, which stick together to form a clot at the injury site. However, with vWD, this clot does not form correctly or may take longer to form, causing heavy bleeding.

In severe cases, bleeding also affects internal organs or joints, leading to a life-threatening situation.

What Are The Types Of Von Willebrand Disease?

The risks or severity of von Willebrand disease depend on its type.

Type 1: This type of vWD is a common condition caused by reduced levels of vWF in your blood. It also affects another protein called factor VIII, which plays a key role in blood clotting by helping to form stable clots. When factor VIII levels are low or its function is impaired, it can contribute to bleeding problems. This type of vWD is usually mild and easily manageable.
Type 2: This type of vWD is caused by the improper functioning of vWF in your blood. There are other subtypes of type 2 that require the identification of gene mutations for the correct treatment.
Type 3: This is the rarest and most severe type of vWD because there is either a very small amount or no vWF in your blood.
Acquired: vWD is most commonly inherired however it can also be acquired later in life due to certain conditions or medications.

How Does Von Willebrand Disease Affect Pregnancy?

vWD does not affect your chances of conceiving. The risk of bleeding may be lower during pregnancy, but it can increase during childbirth and the postpartum period.

When you have type 1 vWD, the vWF levels in your blood often increase during pregnancy and childbirth. The high hormone levels during pregnancy promote the formation of essential blood proteins, which can lead to fewer bleeding episodes.

However, regularly monitoring your clotting levels is still required to prevent any escalations during the last trimester of your pregnancy and delivery.

In type 2 vWD, the vWF level goes up during pregnancy, but the protein does not function properly.

The chances of miscarriage are higher during the first trimester of your pregnancy with type 3 vWD. Also, you may experience heavy bleeding during or after the miscarriage because of the absence of vWF.

The challenge arises after your delivery when the vWF levels may suddenly drop. This can lead to significant blood loss. The risk is higher in individuals with type 2 or type 3 vWD. You may require constant medical care to manage it.

Precautions and Care With Von Willebrand Disease During Pregnancy and After Delivery

You can have a healthy pregnancy and delivery even with vWD. Inform your doctor about your vWD condition so that you get the correct medical care throughout your pregnancy and delivery.

To have a successful pregnancy and delivery, it is best to have the right medical team to care for you. This includes:

Obstetrician (for handling your pregnancy and delivery)
Haematologist (to manage bleeding issues)
Anaesthetist (who is aware of your vWD condition)

Postpartum bleeding with vWD is very common and requires constant monitoring of your vWF and factor VIII levels in your blood. Your haemoglobin levels are also checked to rule out anaemia.

You may experience prolonged bleeding after delivery, making appropriate treatment necessary. The heavy bleeding can lead to a postpartum haemorrhage if not treated in time.

How To Prevent Risks During Pregnancy And Delivery With Von Willebrand Disease?

You can minimise the risks during pregnancy and delivery with vWD by following some important tips.

Inform your doctor about your vWD condition before getting pregnant.
Choose a doctor who specialises in high-risk pregnancies and has a haematologist in their medical team.
Review your pain-relief options for delivery by consulting with the anaesthetist to avoid any intensive procedures.
Consistently monitor your vWF and factor VIII levels through regular blood tests, especially in the last trimester of your pregnancy.
Ask your doctor about any procedures or prenatal tests required to avoid severe blood loss.

Treatment of Von Willebrand Disease

Currently, there is no cure for vWD, but available treatment options can prevent heavy bleeding. The treatment plan depends on the type and severity of your vWD.

If you have mild symptoms of vWD, treatment is only necessary before any surgery, dental work or in the event of an accident.

The treatment method involves medicines that promote the production of vWF and factor VIII in your blood.

Some medicines prevent blood clots from breaking down after they have formed. Your doctor may administer these during surgery or dental procedures.

Self-Care Tips To Manage Von Willebrand Disease During Pregnancy

You can follow some self-care tips to manage your vWD during pregnancy and easily prevent complications.

Inform your doctors about your vWD before starting any medical procedures to avoid injury. Also, inform them about your family history of heavy bleeding.
If you have to visit a dentist during pregnancy, discuss your condition before starting dental work.
Avoid taking any medicines that can thin the blood, especially certain painkillers.
Consider keeping a medical ID with you at all times that states you have vWD and are pregnant. It can be helpful during emergencies.
Although staying active during pregnancy is good, avoid intense activities that can cause injury or bleeding.

Von Willebrand disease during pregnancy can be challenging, as the risk of bleeding is particularly high after you deliver. However, following self-care tips and discussing your conditions and treatment options with your doctor can help in preventing complications.

FAQs on Von Willebrand Disease In Pregnancy

Can von Willebrand disease affect pregnancy?
Von Willebrand disease puts you at a higher risk of bleeding during pregnancy and after childbirth. The main concern is managing maternal bleeding to ensure a safe pregnancy and delivery.
How do you treat von Willebrand disease?
Unfortunately, there is no cure for von Willebrand disease, but you can manage it. Your doctor may suggest medications to stop or prevent excessive bleeding or infusions of Willebrand factor. Infusions involve receiving the missing clotting protein directly into your bloodstream through a vein, helping your blood to clot properly during bleeding episodes or before surgery.
Who is at risk for von Willebrand disease?
Von Willebrand disease can be inherited in different ways depending on the type. Some forms are passed down from one affected parent (autosomal dominant), while others require both parents to carry the gene (autosomal recessive).