Table 1.

Guidelines on Post-Partum Tranexamic Acid for PPH Prevention in VWD

	2017 Royal College of Obstetrics and Gynecology	2018 Canadian Hemophilia Society (Reaffirmed from 2005)	2021 ASH/ISTH/NHF/WFH Guidelines
Prophylactic use of Tranexamic acid?	Yes, qualified Women with VWD should be considered for tranexamic acid for the post partum period. A standard dose is 1 g three to four times a day for 7–14 days. In some cases prolonged use for 2–3 weeks or more may be necessary.	No Should late postpartum hemorrhage occur, tranexamic acid and oral contraceptives are first-line therapy for its management. The risk of thrombosis might be a concern if antifibrinolytics agents are used post partum, but the risk is probably reasonable in women without other risk factors.	Yes The guideline panel suggests the use of tranexamic acid over not using it in women with type 1 VWD or low VWF levels (and this may also apply to types 2 and 3 VWD during the post partum period) (conditional recommendation based on low certainty in the evidence of effects)

Notes: Data from these studies.^14,16,29

Abbreviations: PPH, post partum hemorrhage; VWD, von Willebrand disease; ASH, American Society of Hematology; ISTH, International Society of Thrombosis and Hemostasis; NHF, National Hemophilia Foundation; WFH, World Federation of Hemophilia; VWF, Von Willebrand Factor.