Safety of von Willebrand factor substitution for neuraxial anesthesia in women with persistent von…

ObservationalResearch and practice in thrombosis and haemostasis· May 2026

Safety of von Willebrand factor substitution for neuraxial anesthesia in women with persistent von Willebrand deficiency at delivery.

Yaquine Mechelfekh, Sarah Guérin, Kenza Kali … Brigitte Tardy

Obstetric AnesthesiaObservationalClinical practiceQ1IF 2.8

No spinal epidural hematoma occurred in 40 deliveries using von Willebrand factor substitution during neuraxial anesthesia

Safety of von Willebrand factor substitution for neuraxial anesthesia in women with persistent von Willebrand deficiency at delivery.

Yaquine Mechelfekh … Brigitte Tardy

Research and practice in thrombosis and haemostasis · May 2026

Background

Neuraxial anesthesia (neuraxial anesthesia) constitutes a risk for patients with bleeding disorders, the main hemorrhagic adverse effect being spinal epidural hematoma.

Purpose

This study describes the experience of 8 French hospital centers with neuraxial anesthesia use during delivery in these patients.

Methods

Included in this study manifested still uncorrected von Willebrand factor levels at the end of pregnancy and received neuraxial anesthesia for delivery together with von Willebrand factor substitution to avoid the risk of hemorrhage associated with this type of anesthesia.

n = 32 patients

40

Results

40

no spinal bleeding around the spine in any of these deliveries

n = 32 patients

“

Conclusion · 1 of 2

In conclusion, our results suggest that patients with von Willebrand disease manifesting von Willebrand factor levels not spontaneously corrected by the end of pregnancy could safely benefit from neuraxial anesthesia with closely monitored von Willebrand factor substitution.

Conclusion · 2 of 2

Based on these results and national and international recommendations, we formulated proposals on how to manage these patients.

Safety of von Willebrand factor substitution for neuraxial anesthesia in women with persistent von Willebrand deficiency at delivery.

Safety of von Willebrand factor substitution for neuraxial anesthesia in women with persistent von Willebrand deficiency at delivery.

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