Risk stratification of bleeding risk for the fetus/neonate in women with VWD16
| Risk level . | Possible or confirmed fetal diagnosis . | Suggested management of delivery . |
|---|---|---|
| High | Type 3 VWD | • Discuss MOD, taking maternal and fetal factors into consideration, but avoid midcavity forceps, ventouse delivery; FBS, FSE, rotational forceps, and external cephalic version |
| Medium | Type 2 VWD | • Avoid midcavity forceps, ventouse, rotational forceps, and external cephalic version • Judicious use of FBS and FSE to facilitate vaginal delivery |
| Mild | Clinically moderate or severe type 1 VWD in family | • Consider avoidance of ventouse and external cephalic version • Judicious use of rotational forceps, FBS, and FSE |
| Unlikely to be at risk | Clinically mild type 1 VWD in family | • No special precautions |
| Risk level . | Possible or confirmed fetal diagnosis . | Suggested management of delivery . |
|---|---|---|
| High | Type 3 VWD | • Discuss MOD, taking maternal and fetal factors into consideration, but avoid midcavity forceps, ventouse delivery; FBS, FSE, rotational forceps, and external cephalic version |
| Medium | Type 2 VWD | • Avoid midcavity forceps, ventouse, rotational forceps, and external cephalic version • Judicious use of FBS and FSE to facilitate vaginal delivery |
| Mild | Clinically moderate or severe type 1 VWD in family | • Consider avoidance of ventouse and external cephalic version • Judicious use of rotational forceps, FBS, and FSE |
| Unlikely to be at risk | Clinically mild type 1 VWD in family | • No special precautions |
FBS, fetal blood sampling; FSE, fetal scalp electrode.