Pregnancy complicated by Factor XII deficiency: a case report and literature review

Factor XII deficiency, a rare inherited coagulation disorder, typically presents with isolated prolonged activated partial thromboplastin tim without spontaneous bleeding. Paradoxically, it is associated with thrombotic events and adverse pregnancy outcomes. Evidence-based guidelines for managing FXII deficiency in pregnancy remain lacking.

A 27-year-old primigravida was incidentally diagnosed with severe FXII deficiency during routine prenatal screening. At 38⁺⁵weeks, she presented with vaginal spotting and spontaneous rupture of membranes. A multidisciplinary team planned a cesarean delivery under general anesthesia. Prophylactic fresh frozen plasma (FFP) 400 mL was administered preoperatively. Postoperative FFP (400 mL) was transfused. No bleeding & thrombotic complications occurred in the mother or neonate.

Analysis of 9 publications (19 pregnancies) revealed.

Successful perinatal outcomes hinge on multidisciplinary collaboration, dynamic risk stratification, and personalized bleeding-thrombosis balance. Prophylactic FFP with selective LMWH demonstrated safety in this case. Further studies are needed to optimize standardized pathways.