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Chapter 10: Von Willebrand disease 

Von Willebrand ache (VWD) is the best accepted affiliated bleeding ataxia with 1 in 20,000 bodies actuality afflicted (Favaloro, 2017). The ache is acquired by a abridgement of the Von Willebrand factor (VWF), a array agency that has assorted to functions: actuality a carrier for agglomeration agency 8 (FVIII) and allowing platelets to array and accumulated (Hubert, & VanMeter, 2018). The ache three subtypes, one to three with three actuality best severe. Blazon one is adumbrated by VWF levels beneath than 50IU/dL and blazon 3 with ephemeral VWF levels (Echahdi et al., 2017). Men and women are both appropriately afflicted by VWD about women can be faced with added complications due to menstruation and accouchement (Govorov et al., 2016).  

Purpose

Post-partum drain (PPH) can be a aloft aggravation of childbirth. Studies accept apparent a cogent access in the accident of PPH in women with VWD compared to those afterwards the ache (Govorov et al., 2016). The aloft purpose of the commodity was to investigate the incidence of PPH in women with VWD and examine how PPH accident correlates to anniversary subtype of VWD. The levels of VWF and FVIII during abundance and hemostatic biologic analysis afore and afterwards commitment are additionally advised in this study. 

The conduct of the abstract review

The commodity conduct can be classified under clinical hematology. The advisers advised the lab after-effects of patients to verify the actuality of a absence in the Von Willebrand factor. The analysis explores the if hematologic treatments advice individuals afflicted with VWD abatement the accident of PPH, all hematologic issues, further exemplifying that this abstraction is beneath the hematologic discipline.  

Gaps and issues

Govorov et al. (2016) acclaimed that calm abstracts from the abstraction were bereft in making comparisons of altered subgroups aural the study. To accomplish comparisons accepting added bodies of anniversary VDW subtype would accept been beneficial. With a attenuate ache like VWD, a multi-center study could accept provided added information. Obtaining advice on affectionate claret accident accurately additionally accepted to be an affair in this abstraction due to differences in action amid the accessories congenital in the study.  

Design and methods

Study participants were recruited from the Agglomeration Unit at Karolinska University Hospital in Sweden. Deliveries from 14 altered obstetric units were examined. Researchers focused on women who delivered during 1995-2012. The admittance belief for participants were: a VWD analysis (all subtypes), changeable gender, age 18–50 years, and a history of at atomic one delivery. All women who met the admittance belief were articular and arrive to participate. The abstraction architecture is attendant and observational. 

Sample, size, and setting

34 women and 59 deliveries were included in the study. The age of the women ranged from 19 to 42 years of age. Actuality that VWD is a attenuate ataxia this sample admeasurement is advised to be almost large (Govorov et al., 2016). 

Findings and conclusions

In the group with VWD accident of PPH was college back compared to the accepted accident in healthy individuals. “The accident of primary PPH was 44%, astringent primary PPH 20% and accessory PPH 12%”, (Govorov et al., 2016). VWD type three patients had a college accident of experiencing astringent primary PPH compared to alternative subtypes. Back the analysis of VWD was alien afore abundance researches begin a college accident of PPH as a result. Not receiving homeostatic drugs accepted to access PPH rates among women with VWD.  Low serum FVIII activated with college claret accident during delivery. 

Implications for approaching research 

From this research further can be explored on the ability of different hemostatic drug treatments in blockage PPH. Also, analytic guidelines for women with VWD during abundance can be researched and advised to advice abatement the accident of PPH.  

Application to avant-garde nursing practice 

In avant-garde assistant convenance patients may present with altered hematologic issues and avant-garde convenance nurses should brainwash themselves on those they may appointment in practice. Understanding the issues in women with VDW face, as able-bodied as the hemostatic treatments accessible to these women is important in accouterment affection care. This abstraction shows the importance of anecdotic women with undiagnosed VWD and accepting a absolute medical history of bleeding (personal and familial histories). The abstraction additionally provides admired advice on how altered treatments can abbreviate the outcomes of PPH and the accident of PPH in altered subtypes of the disease.  

Please can you acknowledge to the aloft column in 6-8 sentences , 2 APA architecture references . Thanks

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