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Severe cholestasis-associated coagulopathy diagnosed by routine screening: a case report
Minhazur R Sarker1, Leslie Warren1, Chloe Getrajdman1
1Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, NY.
AJOG Global Reports
|August 30, 2023
Summary
Severe cholestasis of pregnancy may link to vitamin K deficiency. Routine screening for coagulopathy in these cases can detect issues early, enabling timely delivery and a healthy infant.
Area of Science:
- Obstetrics and Gynecology
- Hepatology
- Neonatal Medicine
Background:
- Severe intrahepatic cholestasis of pregnancy (ICP) is linked to fat-soluble vitamin deficiencies.
- Vitamin K deficiency can lead to coagulopathy, increasing risks during pregnancy.
Observation:
- Case report on routine screening for coagulopathy and vitamin deficiencies in severe ICP.
- Screening identified subclinical coagulopathy in a pregnant patient.
Findings:
- Early detection of coagulopathy allowed for timely intervention.
- A healthy neonate was delivered at 34 weeks gestation due to early intervention.
Implications:
- Routine screening for coagulopathy and fat-soluble vitamin deficiency may identify high-risk pregnancies.
- Earlier risk-reducing interventions, such as preterm delivery, can improve neonatal outcomes.
- Prospective studies are needed to confirm the clinical utility of this screening strategy.
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