Recombinant von Willebrand factor use in obstetric anesthesia

Background: In pregnant patients with von Willebrand disease who have reduced von Willebrand factor (VWF) activity but normal factor VIII activity, recombinant VWF may be considered to supplement VWF. Methods: All patients with known diagnosis of von Willebrand disease who were admitted for delivery and received recombinant VWF between October 2019 and March 2023 were included. Demographic data, peripartum course, laboratory data, neuraxial use, and bleeding complications were reviewed. Results: There were 8 deliveries in 6 patients who had von Willebrand disease and received recombinant VWF during the study period. All patients received neuraxial analgesia or anesthesia after administration of recombinant VWF without complications. No patient required additional recombinant VWF supplementation at delivery. Conclusion: Recombinant VWF may be an option for peripartum management in parturients with selective reduction in VWF activity and normal factor VIII activity.