TY - JOUR
T1 - von Willebrand Disease and other hereditary haemostatic factor deficiencies in women with a history of postpartum haemorrhage
AU - Majluf-Cruz, Karim
AU - Anguiano-Robledo, Liliana
AU - Calzada-Mendoza, Claudia C.
AU - Hernández-Juárez, Jesús
AU - Moreno-Hernández, Manuel
AU - Domínguez-Reyes, Víctor Manuel
AU - Figueroa-Torres, Anahi Guadalupe
AU - Gomez-Rosas, Patricia
AU - Arreola-Diaz, Rodrigo
AU - García-Lee, María Teresa
AU - Ricardo-Moreno, María Tania
AU - Sosa-Camas, Rosa Elena
AU - Garcia-Chavez, Jaime
AU - Vela Ojeda, Jorge
AU - Isordia-Salas, Irma
AU - Majluf-Cruz, Abraham
N1 - Publisher Copyright:
© 2019 John Wiley & Sons Ltd
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Introduction: Postpartum haemorrhage (PPH) is the main cause of maternal morbidity and mortality globally, but it is far more important in non-developed countries. PPH represents 25% of all maternal deaths worldwide. Women with von Willebrand disease (VWD) and other inherited haemorrhagic disorders are at increased risk of PPH. Our aim was to establish a probable association of severe PPH in women with a history of haemostatic abnormalities. Methods: An observational, controlled study of adult women with a one or more episodes of severe PPH requiring treatment in an intensive care unit or >10 units of blood products during the 24-hour period after diagnosis and their controls. The tests performed were blood cell count, blood group, renal, viral, liver function and haemostatic tests, fibrinogen, activity of the plasma factors and specific test to diagnose and classify VWD. Results: We included 124 women with 133 PPH events and their controls. The median age at the first event was 25.5 years old. Results were significantly different between the groups in terms of fibrinogen concentration, VWF:Ag, VWF:RCo and FVIII. A specific diagnosis was established in 69 (55.6) and 4 (3.2%) patients in the PPH group and controls, respectively. Of 61 patients with VWD, 57 had type 1, two had type 2A, and another two had type 2B. Conclusion: Our results show a relationship between PPH and inherited haemostatic disorders. VWD was the most frequent diagnosis. Appropriate and opportune diagnosis before pregnancy of inherited haemostatic disorders may be important to effectively prevent and treat PPH.
AB - Introduction: Postpartum haemorrhage (PPH) is the main cause of maternal morbidity and mortality globally, but it is far more important in non-developed countries. PPH represents 25% of all maternal deaths worldwide. Women with von Willebrand disease (VWD) and other inherited haemorrhagic disorders are at increased risk of PPH. Our aim was to establish a probable association of severe PPH in women with a history of haemostatic abnormalities. Methods: An observational, controlled study of adult women with a one or more episodes of severe PPH requiring treatment in an intensive care unit or >10 units of blood products during the 24-hour period after diagnosis and their controls. The tests performed were blood cell count, blood group, renal, viral, liver function and haemostatic tests, fibrinogen, activity of the plasma factors and specific test to diagnose and classify VWD. Results: We included 124 women with 133 PPH events and their controls. The median age at the first event was 25.5 years old. Results were significantly different between the groups in terms of fibrinogen concentration, VWF:Ag, VWF:RCo and FVIII. A specific diagnosis was established in 69 (55.6) and 4 (3.2%) patients in the PPH group and controls, respectively. Of 61 patients with VWD, 57 had type 1, two had type 2A, and another two had type 2B. Conclusion: Our results show a relationship between PPH and inherited haemostatic disorders. VWD was the most frequent diagnosis. Appropriate and opportune diagnosis before pregnancy of inherited haemostatic disorders may be important to effectively prevent and treat PPH.
KW - maternal mortality
KW - postpartum haemorrhage
KW - rare bleeding disorders
KW - von Willebrand disease
KW - von Willebrand factor
UR - http://www.scopus.com/inward/record.url?scp=85076344212&partnerID=8YFLogxK
U2 - 10.1111/hae.13900
DO - 10.1111/hae.13900
M3 - Artículo
C2 - 31823446
AN - SCOPUS:85076344212
SN - 1351-8216
VL - 26
SP - 97
EP - 105
JO - Haemophilia
JF - Haemophilia
IS - 1
ER -