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In all women, von Willebrand factor (VWF) and factor VIII (FVIII) levels increase throughout the third trimester and then decrease to baseline within one month postpartum. There is anecdotal evidence that in women with VWD, this physiologic postpartum decrease in VWF and FVIII levels can be excessive, with their levels reaching even lower than their normal baseline, placing them at a much higher risk of postpartum hemorrhage. The new NHLBI guidelines state that because coagulation factors return to pre-pregnancy levels within 14-21 days, health care providers should be in close contact with women during this period.
"While we know that decreasing VWF levels following childbirth can result in serious complications for women with VWD there are very little clinical data available to guide physicians in treating these patients," said Peter Kouides, MD, a principal investigator of the study and Medical and Research Director of the Mary M. Gooley Hemophilia Center in Rochester, NY, one of the five sites where the study will be conducted. "By studying the patterns in declining VWF levels, we hope to learn whether treatment following birth is needed and the optimum duration of therapy."
The grant will be shared among Duke University Medical Center in Durham, North Carolina, the Mary M. Gooley Hemophilia Center in Rochester, New York, Robert Wood Johnson University Hospital in New Brunswick, New Jersey and two additional study sites. Andra James, MD, of Duke University Medical Center will serve as the study's principal investigator.
Study Design
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