TRANEXAMIC ACID FOR PREVENTION OF POSTPARTUM HEMORRHAGE IN A VERY YOUNG PRIMIPARA WITH VON WILLEBRAND DISEASE
Journal
Македонски медицински преглед = Macedonian Medical Review
Date Issued
2020
Author(s)
Blazheva, Kristina
Abstract
Von Willebrand disease (vWD) is an inherited disorder
in the coagulation process. It occurs due to the quantitative or qualitative lack of the von Willenbrand Factor
(vWF) coagulation factor. It is clinically presented by
mucous bleeding, most commonly nasal, gingival, prolonged and heavy menstrual bleeding, and only in severe forms of the disease, there can be bleeding in the
joints and muscles. Treatment of patients with vWD
focuses on stopping or preventing episodes of bleeding
using medications. With good treatment, patients can
have a normal, healthy life.
Treating pregnant women with vWD is a particular challenge in many respects: pregnancy bleeding, bleeding
in the course of delivery and 4-6 weeks after delivery.
vWD may have varying degrees of clinical severity.
Serious bleeding may occur in patients with miscarriage
or intentional abortion in the first three months of pregnancy due to insufficiently high levels of factor VIII
(FVIII). Bleeding in pregnant patients occurs less frequently due to increased concentrations of FVIII and vWF
during pregnancy. Their values drop sharply during deli-
very and after delivery, so they can cause heavy bleeding.
Postpartum hemorrhage can cause serious problems.
Antifibrinolytic medications are also used to control post-
partum bleeding in patients with vWD. Tranexamic acid
(TxA) belongs to that group of medications and has a
wide range of effects in hemorrhagic conditions.
We present a case of vaginal delivery and postpartum
hemorrhage controlled by TxA in a very young primipara (14 years old) who was diagnosed with vWD and
completed the pregnancy at 36th gestational week.
in the coagulation process. It occurs due to the quantitative or qualitative lack of the von Willenbrand Factor
(vWF) coagulation factor. It is clinically presented by
mucous bleeding, most commonly nasal, gingival, prolonged and heavy menstrual bleeding, and only in severe forms of the disease, there can be bleeding in the
joints and muscles. Treatment of patients with vWD
focuses on stopping or preventing episodes of bleeding
using medications. With good treatment, patients can
have a normal, healthy life.
Treating pregnant women with vWD is a particular challenge in many respects: pregnancy bleeding, bleeding
in the course of delivery and 4-6 weeks after delivery.
vWD may have varying degrees of clinical severity.
Serious bleeding may occur in patients with miscarriage
or intentional abortion in the first three months of pregnancy due to insufficiently high levels of factor VIII
(FVIII). Bleeding in pregnant patients occurs less frequently due to increased concentrations of FVIII and vWF
during pregnancy. Their values drop sharply during deli-
very and after delivery, so they can cause heavy bleeding.
Postpartum hemorrhage can cause serious problems.
Antifibrinolytic medications are also used to control post-
partum bleeding in patients with vWD. Tranexamic acid
(TxA) belongs to that group of medications and has a
wide range of effects in hemorrhagic conditions.
We present a case of vaginal delivery and postpartum
hemorrhage controlled by TxA in a very young primipara (14 years old) who was diagnosed with vWD and
completed the pregnancy at 36th gestational week.
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