Management of Factor X Deficiency for Vaginal Delivery in a Parturient: A Case Report

Factor X (FX) deficiency is a rare coagulopathy that may cause bleeding complications in parturients. The literature on rotational thromboelastometry (ROTEM; Instrumentation Laboratory, Bedford, MA) to guide factor repletion and neuraxial placement during partuition is limited. We present a 17-year-old parturient with FX deficiency after vaginal delivery with neuraxial anesthesia without bleeding complications. After FX concentrate administration, thromboelastometry was utilized to risk-stratify and manage her coagulopathy peripartum. Thromboelastometry may be a valuable adjunct to conventional monitoring in patient management. A limitation of this report is that coagulation tests and thromboelastometry were not assessed at identical timepoints.