Friday, July 23, 2010
23 Year old G2P1A0 with Von Willebrand's disease
I was involved in the labor and delivery phase of this patient's care. She was a pleasant, 23 year old caucasian who had one other pregnancy tha was crried to term. Because of her condition, Von Willebrand's factor was available at the bedside. The patiend elected to have natural childbirth as her first pregnancy was, by her own report, relatively easy. Once she was fully dilated an effaced, she delivered an 8lb 4 oz baby girl after 3 pushes. Amazingly, she did not have any tearing and the bleeding was minimal. What was most interesting to me was the midwives lack of knowledge of Von Willdebrand's disease (which I "educated" them about). I am inclined to think that they had to have learned about it sometime in school, but simply "brain dumped" it due to lack of exposure to the disease.
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Andy,
ReplyDeleteI found myself suggesting that the WHNP test for Von Willdebrand's. We had a patient that we were seeing for colposcopy, but she was less interested in her cervix issues than her worsening menorrhagia-to the point where she was contemplating a hysterectomy at age 27. Each time this patient was seen, her abnormal PAP/colpo exams always took priority over her other issue with the provider. After hearing her history and that of all of the females in her family, Von Willdebrand's came to mind. The provider did order the labs and had me discuss with the patient. I really wish I had the ability to follow-up to see the lab results for this patient.