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Intrahepatic Cholestasis of Pregnancy Leading to Severe Vitamin K Deficiency and Coagulopathy
Joint Authors
Alhousseini, Ali
Gonik, Bernard
Puder, Karoline
Maldonado, Maria
Awadalla, Michael
Idler, Jay
Welch, Robert
Patwardhan, Manasi
Source
Case Reports in Obstetrics and Gynecology
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-06-07
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
Intrahepatic cholestasis of pregnancy is seldom associated with significant vitamin K deficiency.
We report a case of a 16-year-old primigravid patient at 24 weeks and 3 days of gestation who presented with pruritus, hematuria, and preterm labor.
Laboratory work-up showed severe coagulopathy with Prothrombin Time (PT) of 117.8 seconds, International Normalized Ratio (INR) of 10.34, and elevated transaminases suggestive of intrahepatic cholestasis of pregnancy.
Her serum vitamin K level was undetectable (<0.1 nMol/L).
Initial therapy consisted of intramuscular replacement of vitamin K and administration of fresh frozen plasma.
Her hematuria and preterm labor resolved and she was discharged.
She presented in active labor and delivered at 27 weeks and 1 day.
Her bile acids (93 μ/L) and INR (2.32) had worsened.
She delivered a male infant, 1150 grams with Apgar scores 7 and 9.
The newborn received 0.5 mg of intramuscular vitamin K shortly after delivery but went on to develop bilateral grade III intraventricular hemorrhages by day 5.
Intrahepatic cholestasis in pregnancy and nutrition issues were identified as the main risk factors for the severe coagulopathy of this patient.
This case underlines the importance of evaluation of possible severe coagulopathy in patients with intrahepatic cholestasis of pregnancy in order to avoid serious maternal or fetal adverse outcomes.
American Psychological Association (APA)
Maldonado, Maria& Alhousseini, Ali& Awadalla, Michael& Idler, Jay& Welch, Robert& Puder, Karoline…[et al.]. 2017. Intrahepatic Cholestasis of Pregnancy Leading to Severe Vitamin K Deficiency and Coagulopathy. Case Reports in Obstetrics and Gynecology،Vol. 2017, no. 2017, pp.1-3.
https://search.emarefa.net/detail/BIM-1147413
Modern Language Association (MLA)
Maldonado, Maria…[et al.]. Intrahepatic Cholestasis of Pregnancy Leading to Severe Vitamin K Deficiency and Coagulopathy. Case Reports in Obstetrics and Gynecology No. 2017 (2017), pp.1-3.
https://search.emarefa.net/detail/BIM-1147413
American Medical Association (AMA)
Maldonado, Maria& Alhousseini, Ali& Awadalla, Michael& Idler, Jay& Welch, Robert& Puder, Karoline…[et al.]. Intrahepatic Cholestasis of Pregnancy Leading to Severe Vitamin K Deficiency and Coagulopathy. Case Reports in Obstetrics and Gynecology. 2017. Vol. 2017, no. 2017, pp.1-3.
https://search.emarefa.net/detail/BIM-1147413
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1147413