Von Willebrand disease in pregnancy.

Because von Willebrand factor (VWF) levels increase during pregnancy, many women with VWD, though not requiring support with hemostatic agents, are at increased risk for delayed postpartum hemorrhage as coagulation factor levels fall to their prepregnancy levels in the puerperium. Women with moderate or severe disease or complicated pregnancies are best served by delivering at a center with an obstetrician, hematologist, and anesthesiologist experienced in managing coagulation disorders. In addition, on-site laboratory facilities with specialized coagulation testing capability, pharmacy, and blood bank support are critical for success. Ensuring optimal outcomes for pregnant women with VWD requires a multidisciplinary approach.