Document Detail


Combined factor V and VIII deficiency and pregnancy - Need for an early protocol-based multidisciplinary management.
MedLine Citation:
PMID:  24161289     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We report the medical management of a 32-year-old primigravida, after she was found to have a combined factor V (FV) and factor VIII (FVIII) deficiency during pregnancy. A routine coagulation profile performed during the 6th month of pregnancy showed a prolonged activated partial thromboplastin time (aPTT) of 78seconds, giving a patient/control ratio of 2.29, combined with a prothrombin time (PT) of 28seconds. An investigation of the coagulation factors showed a combined FV and FVIII deficiency of 29% and 21% respectively. The bleeding risk was considered to be high. A multidisciplinary approach permitted a specific and individualized FVIII substitution protocol. At 39weeks of amenorrhea, the patient was admitted to the labor room. An infusion of 2000IU of FVIII was implemented over 5minutes; soon thereafter, PT was 17seconds, aPTT patient/control ratio had decreased to 1.9 and FV and FVIII reached 38% and 36% respectively. Six hours later, the patient delivered an infant weighing 2850g who had an Apgar score of 10. No bleeding was detected. The patient was then closely monitored for 2hours in the recovery room. Twelve hours after administration of the first dose of FVIII, another infusion of 2000IU of FVIII was administered. This substitution treatment was continued every 12hours in ever-decreasing doses, allowing maintenance of FVIII level >50% for 5days. At D7 post-partum, the patient was discharged uneventfully.
Authors:
C Hoffmann; E Falzone; A Mihai; L Gitz; N Itzhar-Baikian; S Martel-Jacob; F J Mercier
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-22
Journal Detail:
Title:  Annales francaises d'anesthesie et de reanimation     Volume:  -     ISSN:  1769-6623     ISO Abbreviation:  Ann Fr Anesth Reanim     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8213275     Medline TA:  Ann Fr Anesth Reanim     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.
Affiliation:
Département d'anesthésie-réanimation, Percy military teaching hospital, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France. Electronic address: clement.hoffmann@yahoo.fr.
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