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[Treatment with desmopressin before epidural anesthesia in a patient with type I von Willebrand disease].

Abstract
A 33-year-old primipara with von Willebrand disease type I was admitted in labor at 37 weeks, requesting epidural analgesia. The consultant hematologist advised treating with desmopressin acetate (DDAVP) before inserting an epidural catheter. Desmopressin at a dose of 0.3 microgram/Kg was administered intravenously and the catheter was inserted to L3-L4 to infuse 0.1% bupivacaine with 2 micrograms/mL of fentanyl at a rate of 12 mL/h. Four hours later the patient was brought to the operating room for forceps delivery of a healthy boy. One hour later, she had recovered normal motor tone followed by normal sensitivity in the lower extremities. The catheter was then withdrawn with no signs of bleeding. A woman with von Willebrand's disease can receive an epidural block for analgesia during childbirth. The decision to perform the block should be individualized, based on coagulation tests. DDAVP may play a role in improving hemostasis.
AuthorsP Pérez-Barrero, L Gil, C Martínez, A B Bueno, A I Casado, J Oro
JournalRevista espanola de anestesiologia y reanimacion (Rev Esp Anestesiol Reanim) Vol. 50 Issue 10 Pg. 526-9 (Dec 2003) ISSN: 0034-9356 [Print] Spain
Vernacular TitleTratamiento con desmopresina (DDAVP) previo a la analgesia epidural del parto a una paciente con enfermedad de von Willebrand tipo I.
PMID14737779 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Hemostatics
  • Deamino Arginine Vasopressin
Topics
  • Adult
  • Analgesia, Epidural
  • Analgesia, Obstetrical
  • Deamino Arginine Vasopressin (therapeutic use)
  • Female
  • Hemostatics (therapeutic use)
  • Humans
  • Pregnancy
  • Pregnancy Complications, Cardiovascular (drug therapy)
  • von Willebrand Diseases (drug therapy)

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