How to Identify Patients with von Willebrand’s Disease and Other Coagulation Disorders

Von Willebrand disease (VWD) is globally underdiagnosed in women, however very relevant to prevent complications in obstetrics and if surgery is needed. Many women with VWD may be treated with hormones or experience hysterectomy. Careful history taking is the cornerstone in the approach to diagnose VWD and is considered to be critical in assessing bleeding diathesis. Information about bleeding pattern onset and medical problems should be reviewed carefully to rule out acquired clinical conditions. A positive family history might be a strong indicator for VWD in younger women. Typical symptoms in women with HMB indicating VWD include HMB onset at menarche, bruising, prolonged bleeding from trivial wounds, epistaxis, postpartum hemorrhagia, anemia, and heavy/prolonged bleeding after surgery or dental procedures. Many treatment options of HMB with mild VWD might well incorporate contraception if necessary. In obstetrics close collaboration with the hematologist is recommended.