VWD by the difference in bleeding symptoms. VWD is caused by a deficiency in or a dysfunction of von Willebrand factor (VWF). VWF is a multimeric protein synthesised in megakaryocytes

Inherited bleeding disorders are rare in the general population. Nevertheless, the most common bleeding disorders, haemophilia and von Willebrand disease (VWD), occur in one in 5,000 males and 1% of the general population.1 Since fibrin formation or platelet aggregation in these patients is insufficient, prophylaxis with clotting factor concentrate or desmopressin (DDAVP) prevents severe bleeding complications in situations where optimal haemostasis is crucial, such as surgery. Most patients with either haemophilia or VWD have a relatively mild phenotype, and their disease may well become apparent only after abnormal bleeding postoperatively. In addition, many patients may not be aware of having a bleeding abnormality, since relatives may have the same symptoms. Therefore, it is of the utmost importance to identify patients with underlying bleeding disorders before they undergo surgery. In particular, dentists, gynaecologists and paediatricians should investigate patients for potential bleeding abnormalities.