Kotani Yasushi, Shiota Mitsuru, Umemoto Masahiko, Koike Eiji, Tsuritani Mitsuhiro, Hoshiai Hiroshi
Department of Obstetrics and Gynecology, Kinki University School of Medicine, Osaka, Japan.
J Obstet Gynaecol Res. 2011 Aug;37(8):1102-5. doi: 10.1111/j.1447-0756.2010.01462.x. Epub 2011 Mar 31.
We report a mother and newborn in the puerperium with hemorrhage secondary to factor VIII inhibitor. A 31-year-old gravida 1 para 1 delivered at a local clinic with a massive postpartum hemorrhage. The activated partial thromboplastin time was prolonged and factor VIII inhibitor was detected. The persistent hemorrhage improved following treatment, including transfusion, steroid therapy, and bypass therapy with factor VII formulations. After hysteroscopic removal of the retained placenta, the hemorrhage decreased. The newborn developed significant swelling of the hands after routine blood sampling and factor VIII inhibitor was detected. The inhibitor disappeared without any special treatment in the 5th month postpartum in the mother and the 4th month postpartum in the newborn. Factor VIII inhibitor may be transferred via the placenta from the mother to the fetus. Therefore, the newborn should also be carefully observed in a case of massive hemorrhage after delivery.
