A 34-year-old multiparous woman married for 12 years had four repeated spontaneous abortion. She had profuse bleeding during abortions. Two weeks after the 4th abortion she developed severe headache; a CT scan was taken which showed a left fronto-parietal subdural hematoma. She did not have any history of bleeding tendency or a family history of bleeding disorders. Laboratory findings: Fibrinogen = 23.8 mg/dL Factor VIII activity = 126.3% PT = above 2 minutes aPTT = above 3 minutes TT = 31.8 seconds Questions: (200-400 mg/dL) (50-186%) (12.6-14.6 seconds) (25-35 seconds) (less than or equal to 21 seconds) 1. Which laboratory work-up is correlated with prolonged PT, aPTT and TT? Discuss. 2. What is the possible diagnosis and the effect of the disorder to pregnancy? 3. With the answer in number 1, how does it affect spontaneous abortions and other pregnancy complications?
A 34-year-old multiparous woman married for 12 years had four repeated spontaneous abortion. She had profuse bleeding during abortions. Two weeks after the 4th abortion she developed severe headache; a CT scan was taken which showed a left fronto-parietal subdural hematoma. She did not have any history of bleeding tendency or a family history of bleeding disorders.
Laboratory findings:
Fibrinogen = 23.8 mg/dL Factor VIII activity = 126.3% PT = above 2 minutes aPTT = above 3 minutes
TT = 31.8 seconds Questions:
(200-400 mg/dL) (50-186%)
(12.6-14.6 seconds) (25-35 seconds)
(less than or equal to 21 seconds)
1. Which laboratory work-up is correlated with prolonged PT, aPTT and TT? Discuss.
2. What is the possible diagnosis and the effect of the disorder to pregnancy?
3. With the answer in number 1, how does it affect spontaneous abortions and other
pregnancy complications?
4. Discuss the relationship of the diagnosis with platelet function?
5. State the appropriate therapy and their mechanism of action.
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