Variant von Willebrand's disease and pregnancy
W Hanna, D McCarroll, T McDonald, P Painter, J Tuller, J Chen and R Lange
The clinical course and coagulation profile of a pregnant patient with
variant von Willebrand's disease were followed from the second trimester
through puerperium. The clinical course was characterized by a normal
delivery and absence of abnormal bleeding or need for replacement therapy.
The coagulation profile demonstrated an increase in factor VIII
procoagulant activity, factor-VIII-related antigen, and platelet
aggregation activity in response to ristocetin prior to delivery.
Postpartum, these factors decreased to prepregnancy values with distinctly
different patterns. Factor VIII procoagulant activity continued to rise for
5 days after delivery and then decreased with a half-life of approximately
6 days. Factor-VIII-related antigen began to decrease just prior to
delivery, displaying a half-life or approximately 6 days. Ristocetin
cofactor activity, however, dropped immediately postpartum and displayed a
half-life of approximately 6 hr. The ristocetin cofactor activity was
associated with factor-VIII- related antigen, which displayed a
significantly smaller molecular weight than does normal factor-VIII-related
antigen. Larger aggregates of factor-VIII-related antigen. Larger
aggregates of factor-VIII- related antigen did not appear during the
pregnancy, and ristocetin cofactor activity could not be demonstrated in
fragments of less than 0,8 x 10(6).
Volume 58,
Issue 5,
pp. 873-879,
11/01/1981
Copyright © 1981 by The American Society of Hematology
