Type 3 von Willebrand disease is a rare and severe inherited bleeding disorder that carries an elevated risk for epidural and spinal hematoma as well as pregnancy-associated complications. Neuraxial anesthesia in these patients is controversial but may be considered if the parturient has received appropriate factor replacement. We present the case of a woman with type 3 von Willebrand disease and a severe bleeding history that underwent successful spinal anesthesia during successive cesarean deliveries. Our case highlights the importance of early multidisciplinary consultation and advance planning in the care of these rare events.
From the Departments of *Anesthesia and Perioperative Medicine
†Medicine, Division of Hematology, Queen’s University, Kingston, Ontario, Canada.
Accepted for publication June 18, 2018.
The authors declare no conflicts of interest.
Address correspondence to Jeffrey W. Parker, MD, MBA, CCFP, Department of Anesthesiology, Victory 2, Kingston Health Sciences Centre, 76 Stuart St, Kingston, ON K7L 2V7, Canada. Address e-mail to email@example.com.