The possible causes include: - von Willebrands disease (type II N) - misdiagnosed as haemophilia carrier
- Surgical bleeding with associated coagulopathy
Further investigations would include: - Repeat FVIII level
- vWF factor VIII binding studies
These confirm a rapid fall in the factor VIII level and reduced binding of vWF to FVIII
Treatment - Concentrate containing vWF and FVIII - e.g. Haemate P
- Repeat FVIII levels (aiming for 100 intraop and >50 until wound healinG
- TED stockings only as thromboprophlyaxis
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