Pregnancies in a patient with congenital absence of prothrombin activity: case report.
Congenital hypoprothrombinemias are very rare, inherited disorders in which factor II (prothrombin) levels and/or activity are extremely low or absent. We report eight pregnancies in a patient with this disorder. Obstetric complications attributed to the coagulation disturbance included first-trimester bleeding in each pregnancy, miscarriage in four of the pregnancies, spontaneous maternal subarachnoid hemorrhage in one, and postpartum hemorrhage in one of four term pregnancies despite administration of clotting factor concentrate. The management of pregnancy in congenital hypoprothrombinemia, and issues of coagulation factor replacement, are discussed.
Catanzarite
V A
VA
Mary Birch Hospital for Women at Sharp Memorial, San Diego, California, USA.
Novotny
W F
WF
Cousins
L M
LM
Schneider
J M
JM
D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007020:Hypoprothrombinemias / Q000151:congenital* / Q000188:drug therapy; D010314:Partial Thromboplastin Time; D006473:Postpartum Hemorrhage / Q000209:etiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011516:Prothrombin / Q000032:analysis; D011517:Prothrombin Time; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D014592:Uterine Hemorrhage / Q000209:etiology
D001779:Blood Coagulation Factors; C025667:prothrombin complex concentrates; D011516:Prothrombin