Study to Examine Postpartum Factor Levels

Research examines bleeeding after labor in women with von Willebrand disease
Author: Patrick Hayes

Women with von Willebrand disease (VWD) may soon have fewer worries about dangerous postpartum bleeding. A new study seeks to learn what happens to factor levels after childbirth. CSL Behring is providing a $1.2 million grant to fund this nationwide study, which will determine optimal prophylaxis, or preventive, treatment for postpartum women with VWD. The study is the first of its kind on a national level, and the results could go a long way toward a better understanding of the physiology of VWD after childbirth. It will enable researchers to predict which women will be at risk of bleeding and, if treatment is necessary, how long it should last.

One of the risks for women with VWD following childbirth is severe bleeding. The need for more research is so clear, in fact, that the National Heart, Lung, and Blood Institute noted this need as a top priority in its first clinical guidelines for the diagnosis and treatment of VWD, issued in February 2008.

“Bleeding after delivery is a very common complication. It can occur in up to 20% of women who have von Willebrand disease,” explains Peter Kouides, MD, a co-investigator of the study. He is also medical and research director of the Mary M. Gooley Hemophilia Center in Rochester, New York. “Not all women will have the same risk of bleeding. This study is trying to find out which patients are at the greatest risk of bleeding in terms of trying to determine what happens in general to von Willebrand levels after delivery.”

According to CSL Behring, the study is currently open and will conclude in December 2010. Pregnant women with VWD should speak to their ob/gyn if they are interested in participating. Even if their ob/gyn is not participating in the study, they will be able to refer interested people to the nearest study center. The study centers are in Durham, North Carolina; New Brunswick, New Jersey; Philadelphia; and Rochester, New York.

“We hope that CSL Behring’s support of this groundbreaking study will enable researchers to produce results that clinicians around the world can use in treating women who have VWD,” says Robert Lefebvre, general manager and vice president of US commercial operations at CSL Behring, headquartered in King of Prussia, Pennsylvania.

The study will also examine what happens post-delivery to clotting factor in women who do not have VWD. von Willebrand factor levels rise during the third trimester, but the study will seek to determine whether they fall off immediately after delivery or gradually go back to base levels. The speed at which von Willebrand factor levels fall could be vital information for women with VWD; it will help determine whether postpartum treatment is necessary.

The study’s data will provide physicians with guidelines for treating women with VWD. It will allow them to create a specific treatment plan for patients after labor to head off major bleeding that can result in blood transfusions and other complications.

“The hope is that in the future we can better predict which women will be at risk of bleeding after delivery and when,” says Kouides. “This study will help us intervene sooner rather than later in preventing major bleeding.”