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Viscoelastic testing guided coagulation management in factor VII deficiency for spinal anaesthesia and caesarean

Uzung Yoon1, Shannon Haley2, Suzanne Huffnagle2

  • 1Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA uzyoon@gmail.com.

BMJ Case Reports
|June 20, 2024
PubMed

The risks and benefits of spinal anaesthesia must be assessed in patients with coagulation disorders. A woman in her 20s with congenital factor VII (FVII) deficiency (31%) was admitted at 38 weeks for caesarean delivery. A rotational thromboelastometry (ROTEM) analysis showed normal coagulation and spinal anaesthesia was performed safely. A repeated ROTEM analysis after haemostasis and uterine closure showed normal coagulation without fibrinolysis. No prophylactic FVII was administered, resulting in a cost savings of US$12 884. FVII level did not predict bleeding or fibrinolysis and FVII and tranexamic acid were not indicated.

Keywords:
AnaesthesiaCesarean Section

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