Successful Pregnancy in a Patient with Combined Deficiency of Factor V and Factor VIII

Inherited combined factor V and factor VIII deficiency (F5F8D) is autosomal recessive transmission disorder. Epistaxis, postsurgical bleeding, and menorrhagia are the most common symptoms. The risk of miscarriage and placental abruption is consequent. We report a case of successful pregnancy in a pa...

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Main Authors: Ahmed Ghassan El Adib, Farah Majdi, Mohamed Othmane Dilai, Hamid Asmouki, Ahlam Bassir, Karam Harou, Abderraouf Soumani, Said Younous, Lahoucine Mahmal
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2014/343717
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author Ahmed Ghassan El Adib
Farah Majdi
Mohamed Othmane Dilai
Hamid Asmouki
Ahlam Bassir
Karam Harou
Abderraouf Soumani
Said Younous
Lahoucine Mahmal
author_facet Ahmed Ghassan El Adib
Farah Majdi
Mohamed Othmane Dilai
Hamid Asmouki
Ahlam Bassir
Karam Harou
Abderraouf Soumani
Said Younous
Lahoucine Mahmal
author_sort Ahmed Ghassan El Adib
collection DOAJ
description Inherited combined factor V and factor VIII deficiency (F5F8D) is autosomal recessive transmission disorder. Epistaxis, postsurgical bleeding, and menorrhagia are the most common symptoms. The risk of miscarriage and placental abruption is consequent. We report a case of successful pregnancy in a patient with F5F8D. 20-year-old woman, born of consanguineous parents, third gestate, first parity, two miscarriages, admitted for child birth of a spontaneous pregnancy estimated at 38 weeks and was diagnosed with F5F8D. At admission, patient was hemodynamically stable, with good obstetric conditions. The biologic results showed low levels of PT (52%), factor V (7%), and factor VIII (5%), and the activated partial thromboplastin time was prolonged (68,6%). Parturient was admitted in intensive care unit, maternal and fetal monitoring was performed. Fresh frozen plasma (FFP) and factor VIII concentrates were perfused at the induction of labor. Analgesia used fentanyl titration. The delivery gave birth to a newborn male, with Apgar 10/10 and 3000 g. The puerperium was simple without any important bleeding. Laboratory tests for the newborn were acceptable. Little literature is available on this subject and there are no guidelines available concerning pregnancy; we chose to prescribe a combination of factor VIII concentrate and FFP in pre-, per- and postpartum. The same protocol was successfully used in a patient before dental extraction and prostatectomy. Vaginal delivery is possible, as our case. Management by multidisciplinary team is recommended.
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spelling doaj-art-f3e73efcf2ce4200b8fde923f7c53b792025-08-20T03:25:45ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922014-01-01201410.1155/2014/343717343717Successful Pregnancy in a Patient with Combined Deficiency of Factor V and Factor VIIIAhmed Ghassan El Adib0Farah Majdi1Mohamed Othmane Dilai2Hamid Asmouki3Ahlam Bassir4Karam Harou5Abderraouf Soumani6Said Younous7Lahoucine Mahmal8Department of Anesthesia and Critical Care, University Hospital Mohammed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, MoroccoDepartment of Obstetrics and Gynecology, University Hospital Mohammed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, MoroccoDepartment of Anesthesia and Critical Care, University Hospital Mohammed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, MoroccoDepartment of Obstetrics and Gynecology, University Hospital Mohammed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, MoroccoDepartment of Obstetrics and Gynecology, University Hospital Mohammed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, MoroccoDepartment of Obstetrics and Gynecology, University Hospital Mohammed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, MoroccoDepartment of Obstetrics and Gynecology, University Hospital Mohammed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, MoroccoDepartment of Anesthesia and Critical Care, University Hospital Mohammed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, MoroccoDepartment of Hematology and Oncology, University Hospital Mohammed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, MoroccoInherited combined factor V and factor VIII deficiency (F5F8D) is autosomal recessive transmission disorder. Epistaxis, postsurgical bleeding, and menorrhagia are the most common symptoms. The risk of miscarriage and placental abruption is consequent. We report a case of successful pregnancy in a patient with F5F8D. 20-year-old woman, born of consanguineous parents, third gestate, first parity, two miscarriages, admitted for child birth of a spontaneous pregnancy estimated at 38 weeks and was diagnosed with F5F8D. At admission, patient was hemodynamically stable, with good obstetric conditions. The biologic results showed low levels of PT (52%), factor V (7%), and factor VIII (5%), and the activated partial thromboplastin time was prolonged (68,6%). Parturient was admitted in intensive care unit, maternal and fetal monitoring was performed. Fresh frozen plasma (FFP) and factor VIII concentrates were perfused at the induction of labor. Analgesia used fentanyl titration. The delivery gave birth to a newborn male, with Apgar 10/10 and 3000 g. The puerperium was simple without any important bleeding. Laboratory tests for the newborn were acceptable. Little literature is available on this subject and there are no guidelines available concerning pregnancy; we chose to prescribe a combination of factor VIII concentrate and FFP in pre-, per- and postpartum. The same protocol was successfully used in a patient before dental extraction and prostatectomy. Vaginal delivery is possible, as our case. Management by multidisciplinary team is recommended.http://dx.doi.org/10.1155/2014/343717
spellingShingle Ahmed Ghassan El Adib
Farah Majdi
Mohamed Othmane Dilai
Hamid Asmouki
Ahlam Bassir
Karam Harou
Abderraouf Soumani
Said Younous
Lahoucine Mahmal
Successful Pregnancy in a Patient with Combined Deficiency of Factor V and Factor VIII
Case Reports in Obstetrics and Gynecology
title Successful Pregnancy in a Patient with Combined Deficiency of Factor V and Factor VIII
title_full Successful Pregnancy in a Patient with Combined Deficiency of Factor V and Factor VIII
title_fullStr Successful Pregnancy in a Patient with Combined Deficiency of Factor V and Factor VIII
title_full_unstemmed Successful Pregnancy in a Patient with Combined Deficiency of Factor V and Factor VIII
title_short Successful Pregnancy in a Patient with Combined Deficiency of Factor V and Factor VIII
title_sort successful pregnancy in a patient with combined deficiency of factor v and factor viii
url http://dx.doi.org/10.1155/2014/343717
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