VWD MANAGEMENT

CLINICAL PRACTICE GUIDELINES
Hemophilia and von Willebrand's disease: 2. Management
(Edition 2, Update 2 [1999-07-07])

Given the hereditary nature of these bleeding disorders, family members will be concerned about their carrier status and the risk to future children. These concerns can be addressed through genetic counselling for the extended family and, when appropriate, through carrier testing and antenatal diagnosis.<17> The emotional and psychologic stress of living with a severe bleeding disorder or of caring for someone with such a disorder may necessitate psychologic counselling. As a result of HIV, hepatitis C and hepatitis B infections, counselling needs for families have increased drastically.<18> Practice of universal blood precautions reduces the risk of viral transmission to family members. Sexual partners of those infected with HIV and HBV through contaminated blood products are at risk of acquiring HIV or HBV. Present knowledge suggests the concern is less for sexual partners of those infected with HCV.<19>. As for all patients with HIV and HBV infections and their partners, education about safer sexual and other practices to reduce infection transmission must be provided.<20> Susceptible family members of those infected with hepatitis B must be protected by hepatitis B vaccination.

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