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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
PubMed

Insights

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.

Keywords:
bile acidscase reportcholestasisfat-soluble vitaminsliver transplantvitamin K

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