Specific therapy at the time of delivery for VWD subtypes
| Subtype . | Specific therapy for VWD . |
|---|---|
| 1 | • Most will not require treatment. • If VWF levels <50% or 0.5 IU/mL at 36 weeks' gestation, treatment is required at the time of delivery. A higher threshold for treatment such as 0.8 IU/dL or 1.0 IU/mL has been adopted by some experts and may be considered. • VWF and FVIII levels should be followed to guide dosing. • Consider cautious use of desmopressin if a desmopressin trial was performed outside of pregnancy and efficacy was documented. |
| 2 | Expect that treatment will be required with VWF concentrates. |
| 2A | • Most will require VWF concentrates. • Some may respond to desmopressin (requires previous desmopressin trial with documented efficacy). |
| 2B | • Treat with VWF concentrates. • Desmopressin is contraindicated as it may worsen thrombocytopenia. |
| 2M | • Most will require VWF concentrates. • Some may respond to desmopressin (requires previous desmopressin trial with documented efficacy). |
| 2N | • Most will require VWF concentrates. • Some may respond to desmopressin (requires previous desmopressin trial with documented efficacy). |
| 3 | • Requires VWF concentrates. |
| Subtype . | Specific therapy for VWD . |
|---|---|
| 1 | • Most will not require treatment. • If VWF levels <50% or 0.5 IU/mL at 36 weeks' gestation, treatment is required at the time of delivery. A higher threshold for treatment such as 0.8 IU/dL or 1.0 IU/mL has been adopted by some experts and may be considered. • VWF and FVIII levels should be followed to guide dosing. • Consider cautious use of desmopressin if a desmopressin trial was performed outside of pregnancy and efficacy was documented. |
| 2 | Expect that treatment will be required with VWF concentrates. |
| 2A | • Most will require VWF concentrates. • Some may respond to desmopressin (requires previous desmopressin trial with documented efficacy). |
| 2B | • Treat with VWF concentrates. • Desmopressin is contraindicated as it may worsen thrombocytopenia. |
| 2M | • Most will require VWF concentrates. • Some may respond to desmopressin (requires previous desmopressin trial with documented efficacy). |
| 2N | • Most will require VWF concentrates. • Some may respond to desmopressin (requires previous desmopressin trial with documented efficacy). |
| 3 | • Requires VWF concentrates. |