Von Willebrand disease

Most VWD patients will require intermittent acute treatment for active bleeding or before procedures throughout their lives, but will respond well to treatment. All patients with VWD should avoid medications that inhibit platelet function, as they will increase bleeding symptoms.

In people without VWD, von Willebrand levels increase with age. In patients with mild type 1 VWD, levels may increase with aging. In patients with types 2 or 3 VWD, symptoms may increase with age because of the frequency of gastrointestinal bleeding in this population.

Von Willebrand factor and factor VIII levels increase during pregnancy, and in type 1 disease are usually in the normal range by the third trimester and treatment is not needed at the time of delivery. Patients with type 2 or 3 VWD may require factor support at the time of delivery and should be managed collaboratively by specialists in hematology and high-risk obstetrics. All patients are at increased risk for postpartum hemorrhage, especially delayed.