Gynaecological and obstetrical morbidity in women with type I von Willebrand disease: Results of a patient survey

P. A. Kouides, P. D. Phatak, P. Burkart, C. Braggins, C. Cox, Z. Bernstein, L. Belling, P. Holmberg, W. Maclaughlin, F. Howard

Research output: Contribution to journalArticlepeer-review

152 Scopus citations


Type 1 von Willebrand disease (vWD) is generally regarded clinically as 'mild' and the obstetrical-gynaecological features have not been fully described. We administered a patient questionnaire and provider survey of the medical and quality of life aspects of childbirth and menstruation to 99 type 1 vWD patients and compared the patients presently menstruating (n = 81) to a cohort of 150 menstruating females in the general population. The following measurements had a statistically higher proportion in the vWD group: number of tampons/towels used for a typical menstrual cycle (P = 0.002); percentage reporting that clothes are stained by menses (P = 0.001); past or present history of anaemia (P = 0.001); childbirth-related bleeding (P = 0.001); and childbirth-related bleeding necessitating RBC transfusion (P = 0.002). Quality of life assessment of the impact of menses in both of the above cohorts was measured by a Likert scale using seven quality of life parameters. Compared to the control group, the vWD patients had a significantly higher score, with P-values of < 0.0001 for each parameter. Hormonal interventions for menorrhagia in the vWD patients were ≤ 50% effective. Menorrhagia resulted in red blood cell transfusions in 6% of patients, dilatation and curettage in 17% and hysterectomy in 13%. Despite the common connotation of type 1 vWD as clinically 'mild', childbirth and the monthly challenge to haemostasis presented by menstruation result in a substantial degree of morbidity in females with type 1 vWD. These results support the rationale for ongoing international efforts to increase awareness of vWD as a cause for menorrhagia and to improve the quality of life in females with known vWD.

Original languageEnglish (US)
Pages (from-to)643-648
Number of pages6
Issue number6
StatePublished - 2000
Externally publishedYes


  • Gynaecology
  • Menorrhagia
  • Obstetrics
  • Postpartum haemorrhage
  • Quality of life
  • Von willebrand disease

ASJC Scopus subject areas

  • Hematology
  • Genetics(clinical)


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