Author(s): MA?GORZATA ZEMBALA-SZCZERBA, HUBERT HURAS
Von Willebrand disease is the most common plasma hemorrhagic diathesis and at the sametime one of the most common coagulation abnormality of non-obstetric origin encounteredduring pregnancies.The work describes the cases of two patients hospitalized during the near-birth period in theCMUJ Obstetric and Perinatology Clinic. In both cases these were full duration pregnanciesthat were ended by caesarian sections due to obstetric indications. The diagnosis of vonWillebrand was made prior to the pregnancy – as there were serious disturbances of haemo-stasis – in the first case type 3, in the other type 2B. In case of the first patient the haemo-stasis was achieved after implementation of proper surgery preparation and post-surgical tre-atment. Unfortunately, although proper birth related procedures were put in place, the secondpatient developed the most serious complication, that is the postpartum hemorrhage, thatresulted in surgical removal of the uterus.The supervision of patients with coagulation abnormalities during pregnancy, birth and child-bed poses a great challenge. Proper diagnosis and appropriate treatment requires, in most cases,the individual approach and the close cooperation of the obstetrician, hematologist, anesthe-tist and the neonatologist. Even treatment that is performed according to the current recom-mendations does not guarantee a birth that would be free of complications.