Von Willebrand disease (VWD) and pregnancy: a comprehensive overview

Abstract Von Willebrand disease (VWD) is a hereditary bleeding disorder characterized by a quantitative or qualitative deficiency of von Willebrand factor (VWF). Pregnancy significantly impacts hemostasis, leading to a hypercoagulable state. However, women with VWD experience unique challenges due t...

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Main Authors: Hamed Soleimani Samarkhazan, Mohammad Navid khaksari, Ali Rahmati, Mahsa Loran Esfahani, Amin Solouki, Mojtaba Aghaei
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Thrombosis Journal
Subjects:
Online Access:https://doi.org/10.1186/s12959-025-00727-7
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author Hamed Soleimani Samarkhazan
Mohammad Navid khaksari
Ali Rahmati
Mahsa Loran Esfahani
Amin Solouki
Mojtaba Aghaei
author_facet Hamed Soleimani Samarkhazan
Mohammad Navid khaksari
Ali Rahmati
Mahsa Loran Esfahani
Amin Solouki
Mojtaba Aghaei
author_sort Hamed Soleimani Samarkhazan
collection DOAJ
description Abstract Von Willebrand disease (VWD) is a hereditary bleeding disorder characterized by a quantitative or qualitative deficiency of von Willebrand factor (VWF). Pregnancy significantly impacts hemostasis, leading to a hypercoagulable state. However, women with VWD experience unique challenges due to the interplay between pregnancy-related hormonal changes and VWF deficiencies. This review delves into the intricate relationship between VWD and pregnancy. We explored the physiological changes that occur during pregnancy, including hormonal fluctuations, hemodilution, and alterations in platelet–VWF interactions. We discuss how these changes can exacerbate bleeding tendencies in women with VWD, particularly during childbirth and the postpartum period. This review highlights the increased risk of postpartum hemorrhage (PPH) in women with VWD and the potential for severe maternal morbidity and mortality. We examine the various types of VWD and their specific implications for pregnancy outcomes. Additionally, we discuss the challenges associated with diagnosing and managing VWD during pregnancy, as well as the importance of prenatal counseling and careful monitoring. The management of VWD during pregnancy involves a multidisciplinary approach, including the use of prophylactic treatments, such as desmopressin and tranexamic acid, as well as factor replacement therapy when necessary. Careful planning of delivery, including the choice of delivery mode and the timing of interventions, is essential to minimize bleeding complications. By understanding the complexities of VWD during pregnancy and implementing appropriate management strategies, healthcare providers can significantly improve the outcomes for women with VWD and their offspring.
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spelling doaj-art-8e54ad3822374e8fa0829bcdb27626a02025-08-20T02:55:23ZengBMCThrombosis Journal1477-95602025-04-0123111110.1186/s12959-025-00727-7Von Willebrand disease (VWD) and pregnancy: a comprehensive overviewHamed Soleimani Samarkhazan0Mohammad Navid khaksari1Ali Rahmati2Mahsa Loran Esfahani3Amin Solouki4Mojtaba Aghaei5Student Research Committee, Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical SciencesDepartment of Hematology and Blood Banking, Faculty of Medicine, Mashhad University of Medical SciencesDepartment of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical SciencesDepartment of Medical Laboratory Sciences, School of Allied Medicine, Kermanshah University of Medical SciencesDepartment of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical SciencesStudent Research Committee, Ahvaz Jundishapur University of Medical SciencesAbstract Von Willebrand disease (VWD) is a hereditary bleeding disorder characterized by a quantitative or qualitative deficiency of von Willebrand factor (VWF). Pregnancy significantly impacts hemostasis, leading to a hypercoagulable state. However, women with VWD experience unique challenges due to the interplay between pregnancy-related hormonal changes and VWF deficiencies. This review delves into the intricate relationship between VWD and pregnancy. We explored the physiological changes that occur during pregnancy, including hormonal fluctuations, hemodilution, and alterations in platelet–VWF interactions. We discuss how these changes can exacerbate bleeding tendencies in women with VWD, particularly during childbirth and the postpartum period. This review highlights the increased risk of postpartum hemorrhage (PPH) in women with VWD and the potential for severe maternal morbidity and mortality. We examine the various types of VWD and their specific implications for pregnancy outcomes. Additionally, we discuss the challenges associated with diagnosing and managing VWD during pregnancy, as well as the importance of prenatal counseling and careful monitoring. The management of VWD during pregnancy involves a multidisciplinary approach, including the use of prophylactic treatments, such as desmopressin and tranexamic acid, as well as factor replacement therapy when necessary. Careful planning of delivery, including the choice of delivery mode and the timing of interventions, is essential to minimize bleeding complications. By understanding the complexities of VWD during pregnancy and implementing appropriate management strategies, healthcare providers can significantly improve the outcomes for women with VWD and their offspring.https://doi.org/10.1186/s12959-025-00727-7Von Willebrand diseasePregnancyHemostasisPlateletPostpartum hemorrhageBleeding disorders
spellingShingle Hamed Soleimani Samarkhazan
Mohammad Navid khaksari
Ali Rahmati
Mahsa Loran Esfahani
Amin Solouki
Mojtaba Aghaei
Von Willebrand disease (VWD) and pregnancy: a comprehensive overview
Thrombosis Journal
Von Willebrand disease
Pregnancy
Hemostasis
Platelet
Postpartum hemorrhage
Bleeding disorders
title Von Willebrand disease (VWD) and pregnancy: a comprehensive overview
title_full Von Willebrand disease (VWD) and pregnancy: a comprehensive overview
title_fullStr Von Willebrand disease (VWD) and pregnancy: a comprehensive overview
title_full_unstemmed Von Willebrand disease (VWD) and pregnancy: a comprehensive overview
title_short Von Willebrand disease (VWD) and pregnancy: a comprehensive overview
title_sort von willebrand disease vwd and pregnancy a comprehensive overview
topic Von Willebrand disease
Pregnancy
Hemostasis
Platelet
Postpartum hemorrhage
Bleeding disorders
url https://doi.org/10.1186/s12959-025-00727-7
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