title: Management of gynecologic surgery in the patient with factor XI deficiency: a review of the literature.
abstract: Factor XI deficiency is a rare bleeding disorder that is more commonly found in Ashkenazi Jews. Bleeding manifestations of this disorder are varied and poorly correlate with factor XI levels. Spontaneous bleeding is uncommon, whereas delayed postoperative bleeding is often the presentation of factor XI deficiency. To date, there are no standard recommendations for prophylactic treatment in women undergoing gynecologic surgery. Here, we review published cases of gynecological surgery in women with factor XI deficiency and discuss the risks and benefits of various therapeutic options.
  
  
  BACKGROUND
  Obstetricians And Gynecologists.
  
  
  OBJECTIVE
  After participating in this activity, physicians should be better able to identify the pathophysiology of factor XI deficiency. Compare previous outcomes of prophylactic treatment in patients with factor XI deficiency undergoing gynecological surgery. Implement possible prophylactic therapies for patients with factor XI deficiency undergoing gynecological surgery.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology Duke University Medical Center, Durham, NC, USA.
authors.forename: Ryan G
authors.initials: RG
authors.lastname: Steward
authors.forename: Oussama A
authors.initials: OA
authors.lastname: Saleh
authors.forename: Andra H
authors.initials: AH
authors.lastname: James
authors.forename: Anish A
authors.initials: AA
authors.lastname: Shah
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Price
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D015942:Factor VIIa / Q000627:therapeutic use; D005172:Factor XI / Q000627:therapeutic use; D005173:Factor XI Deficiency / Q000150:complications*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006487:Hemostasis; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D010949:Plasma; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D000933:Antifibrinolytic Agents; D006490:Hemostatics; D011994:Recombinant Proteins; D005172:Factor XI; C103587:recombinant FVIIa; D015942:Factor VIIa; D003894:Deamino Arginine Vasopressin