Am J Perinatol 2008; 25(3): 189-192
DOI: 10.1055/s-2008-1061499
© Thieme Medical Publishers

Plasma Exchange in a Case of Severe Factor X Deficiency in Pregnancy: Critical Review of the Literature

Giuseppe Chiossi1 , Joel A. Spero2 , Emmanuel J. Esaka1 , Kristin Novic1 , Jennifer U. Celebrezze1 , Steven H. Golde1 , Ronald L. Thomas1
  • 1Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania
  • 2Department of Human Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania
Further Information

Publication History

Publication Date:
29 February 2008 (online)

ABSTRACT

Hereditary factor X deficiency represents an uncommon challenge in pregnancy. A 30-year-old primigravida affected by severe factor X deficiency was followed from 6 weeks of gestation until delivery. Factor X was provided prior to delivery for the first time in pregnancy via plasma exchange. The pregnancy and postpartum period were not complicated by bleeding episodes; therefore this approach was accompanied by lower cost and fewer side effects when compared with fresh-frozen plasma and prothrombin complex concentrates infusion, two therapeutic options already used in pregnancy.

REFERENCES

  • 1 Uprichard J, Perry D J. Factor X deficiency.  Blood Rev. 2002;  16 97-110
  • 2 Konje J C, Murphy P, de Chazal R, Davidson A, Taylor D. Severe factor X deficiency and successful pregnancy.  Br J Obstet Gynaecol. 1994;  101 910-911
  • 3 Larrain C. Congenital blood coagulation factor X deficiency. Successful result of the use of prothrombin concentrated complex in the control of cesarean section hemorrhage in 2 pregnancies.  Rev Med Chil. 1994;  122 1178-1183
  • 4 Kumar M, Mehta P. Congenital coagulopathies and pregnancy: report of four pregnancies in a factor X deficient woman.  Am J Hematol. 1994;  46 241-244
  • 5 Bofill J A, Young R A, Perry K G. Successful pregnancy in a woman with severe factor X deficiency.  Obstet Gynecol. 1996;  88 723
  • 6 Rezig K, Diar N, Benabidallah D, Audibert J. Déficit en facteur X et grossesse.  Ann Fr Anesth Reanim. 2002;  21 521-524
  • 7 Romagnolo C, Burati S, Ciaffoni S et al.. Severe factor X deficiency in pregnancy: case report and review of literature.  Haemophilia. 2004;  10 665-668
  • 8 Seligsohn U, Zivelin A, Inbal A. Inherited deficiencies of coagulation factors II, V, VII, X, XI and XIII and combined deficiencies of factors V and VII and the vitamin K dependent factors. In: Lichtman MA, Beutler E, Kipps JT, Seligsohn U, Kaushansky K, Prchal JT Williams Hematology. 7th ed. New York; McGraw-Hill 1996: 1887-1928
  • 9 Edmunds Jr L H. Hemostatic problems in surgical patients. In: Colman RW, Marder VJ, Clowes AW, George JN, Goldhaber SZ Hemostasis and Thrombosis. 5th ed. Philadelphia; Lippincott Williams & Wilkins 2006: 1106-1118
  • 10 Spero J A. Plasma exchange for coagulopathy and/or coagulation inhibitors.  J Clin Apher. 1985;  2 278-281
  • 11 Beardell F V, Varma M, Martinez J. Normalization of plasma factor X levels in amyloidosis after plasma exchange.  Am J Hematol. 1997;  54 68-71
  • 12 Weinstein R. Plasma exchange. In: McLeod B, Price T, Weinstein R Apheresis: Principle and Practice. 2nd ed. Bethesda, MD; American Association of Blood Banks (AABB) 2003: 313
  • 13 Girolami A, Lazzarini M, Scarpa R, Brunetti A. Further studies on the abnormal factor X (factor X Friuli) coagulation disorder: a report of another family.  Blood. 1971;  37 534-541

Giuseppe ChiossiM.D. 

Department of Obstetrics and Gynecology, Allegheny General Hospital

7th Floor South Tower, 320 East North Avenue, Pittsburgh, PA 15212

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