WOMENS-HEALTH Messages for July, 1999: Re: von Willebrand's ANYBODY !!!!!

Re: von Willebrand's ANYBODY !!!!!

From: Harvey Marchbein. M.D. (anonymous@obgyn.net)
Mon, 26 Jul 1999 12:40:15 -0500 (CDT)

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At Sun, 25 Jul 1999, Dawn wrote: >
>I posted original questions on July 19. Have rec'd no input whatsoever,
>not surprising as many do not know about this disease. But do ANY of
>the doctors out here?? Can anyone help by answering our questions? My
>daughter is scheduled to be induced on August 2, in only ONE WEEK!!.
>Please, if any doctors can answer our questions..please feel free to do
>so.
>
>Thanks.

I went back and got the posting so I could help. For all you out there, if a question is not answered, please restate the question in its entirety.

"My daughter, first pregnancy, age 20. Diagnosed with Classic Type I vWillebrand's Disease at age 15. Extreme bleeding during periods. normal Factor VIII levels, EXTREMELY low ristocetin cofactor (.28). Her pre pregnancy bleeding time varied between 9-15 minutes.

-OK-

Small uterus, is under care of high risk OBGYN, who has NOT ever delivered a vW patient before. Also has haemotologist (actually two, one local, one an hour away where she is to deliver).

-Small? vonWillebrands doesn't make it small. Hematologists are a good idea.-

We JUST found out she cannot have any spinal anesthesia !! GADS !!. We didn't know that. They are to induce her on August 2nd.

-Spinal anesthesia may disrupt a blood vessel because it is done carefully, but by feel, not direct vision.-

What if any problems with excess bleeding are common to vW patients at delivery? We were told that Classic Type I vW patients usually bleed much more from mucosa membranes. Is this true? and does that make delivery MORE of a problem?

-Usually, vonWillebrands patients do very well without problems.-

We have also been told that the delivery should be unremarkable, but the chance of hemorrage during the post delivery time (up to 8 weeks post delivery) is the REAL concern?

-Possible but small.-

Also, we have learned that the baby stands a good chance of being vW also, it is a girl, they are guesssing 7.5 - 9# at birth.

We were warned about cerebral hemoragge of the baby.

-Possible but not common.-

ANY help to either enlighten us, or dispel fears would be GREATLY appreciated. We live in a small upstate WV community and NO one has ever even HEARD Of vW Disease up here. She is being treated in Youngstown Ohio. The hospital is a regional Hemophilia Treatment Center.

-You don't get better than the Regional Hemophilia Center.-

Thanks for any replies !! "

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York
http://www.obgyn.net/states/bios/marchbein.htm
http://www.obgyn.net/women/advisors/harveym.htm

**Note:  Opinions expressed here are for educational purposes only
and, as such, do not constitute a physician-patient relationship.
This information is not intended to supplant the need for you to
consult with your physician prior to choosing therapeutic options
and/or interventions.

**Private emails cannot be entertained due to time constraints,
consequently no private emails will receive a response.

**Thank you for your understanding ;-)

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