Table 1.
Patient characteristics (n = 46 women, 179 samples).
Table 2.
VWF-associated parameters in 46 women during pregnancy and at non-pregnant baseline (Fig 1).
Figure 1.
VWF-associated parameter data in 46 pregnancies.
Values for VWF:Ag (A), FVIII (B), VWFpp (C), FVIII:VWF Ratio (D), VWFpp:Ag Ratio (E) are presented at each time point (non-pregnant baseline n = 46, 1st trimester n = 24, 2nd trimester n = 38, 3rd trimester n = 46). The median, 25th and 75th percentiles (boxed), 1 SD (bars), and individual outlying data points (black dots) are shown for each parameter at each time point. Statistically significant differences from baseline (p<0.05 by one-way ANOVA followed by all pairwise multiple comparisons) are indicated by asterisks (*). Values can be found in Table 2.
Table 3.
Hemostatic parameters (± SD) at baseline and in the 3rd trimester of 46 healthy pregnancies.
Table 4.
Changes in VWF-associated parameters (relative to non-pregnant baseline) in 46 pregnancies (Fig 2).
Figure 2.
Changes in VWF-associated parameters from baseline in 46 pregnancies.
The changes in VWF parameters normalized to baseline are displayed longitudinally over pregnancy for time points sampled in pre-pregnancy n = 14, 1st trimester n = 24, 2nd trimester n = 38, 3rd trimester n = 44, 38wks n = 12, and postpartum n = 41. Asterisks (*) indicate p<0.05 compared to postpartum values (one-way ANOVA, all pairwise multiple comparisons). Standard deviations, means, 25th, and 75th percentiles are omitted for clarity and can be found in Table 4.
Table 5.
Calculated VWF excess and VWF half-life in pregnancy.
Table 6.
ABO types of the 46 pregnant subjects.
Table 7.
VWF parameter changes in pregnancy from non-pregnant baseline by ABO blood group.
Figure 3.
Loss of higher weight VWF multimers in pregnancy.
A normalized 1% multimer gel (A) and densitometry (B) of plasma VWF multimers from a single pregnancy demonstrating the most commonly observed pattern of shifted VWF multimers (arrows) in the second trimester (orange) and third trimester (red) compared to baseline VWF (blue).
Figure 4.
Change in VWF triplet structure in pregnancy.
A normalized high resolution 2.6% multimer gel (A) and densitometry (B) of the same pregnancy shown in Fig 3 demonstrating the most commonly observed pattern of shifted VWF triplet structure with relative loss of height of the major band in the 3rd trimester (red) compared to baseline (blue).
Figure 5.
Shift in isoelectric focus (IEF) pattern in pregnancy.
A. A normalized plasma isoelectric focusing gel from the same pregnancy as shown in Figs 3 and 4 immunoblotted for VWF. B. Densitometry tracings demonstrate the progressive shift in VWF isolectric focus in the 2nd (orange) and 3rd (red) trimesters. In the 3rd trimester, the band volume ratio of VWF in the doublet has shifted (3∶1 to nearly 2∶1) and the upper VWF band has shifted towards the lower pH focused VWF band.