Just Heavy Menses or Something More? Raising Awareness of von Willebrand Disease

Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA.
The American journal of nursing (Impact Factor: 1.3). 05/2012; 112(6):38-44; quiz 46, 45. DOI: 10.1097/01.NAJ.0000415122.54111.f4
Source: PubMed


OVERVIEW: Von Willebrand disease is the most common inherited bleeding disorder, with an estimated prevalence of up to 1.3% of the U.S. population, or 4 million Americans. It's caused by a deficiency of or defects in von Willebrand factor, a protein necessary for blood to clot. Many nurses and other health care providers, as well as patients, are unaware of the disorder, its symptoms, and its associated risks. Although the disorder occurs equally in males and females, it can be more troublesome in females. Heavy menses beginning at menarche is one of the most common presentations, but because the disorder is inherited and other family members may have similarly heavy menses, the assumption may be that this is normal. This article describes von Willebrand disease and its three types, explains how to recognize and investigate suggestive symptoms, and outlines management strategies.

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    ABSTRACT: Background: Menorrhagia is a common health problem in women, particularly those with bleeding disorders. Little is known about the course of menorrhagia or other bleeding symptoms in women with the most common congenital bleeding disorder, von Willebrand disease (vWD). Objectives: The aim of this study was to estimate the prevalence of vWD in women with diagnosed menorrhagia. Materials and Methods: In this cross-sectional study, a total of 460 consecutive patients, presenting menorrhagia, were analyzed. The initial screening and confirmation tests for the diagnosis of vWD included determination of prothrombin time (PT), partial thromboplastin time (PTT), bleeding time (BT), fibrinogen, factor VIII, vWF antigen, and vWF activity. A questionnaire was filled for every patient. The data were then analyzed using the SPSS software. Results: Mean age of our patients was 32.5 ± 10.6 years. The level of von Willebrand factor in 22.5% and von Willebrand activity in 19.6% of patients was abnormal. The prevalence of vWD among patients with menorrhagia was 24%. Conclusions: The high prevalence of vWD among our patients was the same as other previous reports, suggesting low awareness about this disease and under diagnosis of mild cases.
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