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Updated: Nov 18, 2025

Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
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Accidentally discovered high INR in pregnancy unmasks an inherited factor VII (FVII) deficiency that is paradoxically

Islam Tarek Elkhateb1, Abdalla Mousa2, Riham Mohye Eldeen3

  • 1Obstetrics and Gynecology Department, Newgiza University, Giza, Giza, Egypt.

BMJ Case Reports
|February 5, 2021
PubMed

A 32-year-old multiparous obese woman was referred to our center at 37 weeks of twin gestation. She was referred for birth planning following an accidentally discovered high international normalised ratio (INR) in routine preoperative labs. Her history was significant for recurrent pregnancy-associated deep venous thrombosis as well as two early pregnancy losses. Further work-up revealed transaminitis, mild splenomegaly and high lupus anticoagulant titre. A multidisciplinary team of physicians from the high-risk pregnancy, anaesthesiology, haematology, gastroenterology and hepatology departments put a management plan; it culminated into uncomplicated delivery of the patient by repeated caesarian section. The team was also able to figure out the cause of the patient's high INR that is associated with thrombophilia rather than haemophilia.

Keywords:
anaesthesiahaematology (incl blood transfusion)hepatitis and other GI infectionspregnancyvenous thromboembolism

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