{
  "abstract": "Background Factor VII deficiency is considered a contraindication to neuraxial anesthesia due to the risk of an epidural hematoma.Case Report A 32 year old G1P0 parturient with severe factor VII deficiency presented for an anesthesiology consultation at 32 weeks gestation. Initial coagulation studies were significant for an elevated INR (2.0) and a low factor VII level of 6%. After interdisciplinary discussion, it was decided that neuraxial analgesia could be offered if her coagulation studies corrected after administration of recombinant activated factor VII (rFVIIa). The patient presented at 36 weeks gestation for a rFVIIa challenge. She received 22 mcg/kg rFVIIa and coagulation studies were analyzed 20 minutes later which showed complete correction of the coagulopathy. The patient presented to the hospital at 39 weeks and 3 days for delivery, received 2 mg rFVIIa and 20 minutes later, successfully received an epidural catheter. Her INR was monitored every 3 hours during her labor course and rFVIIa was given if the INR was 1.3 or greater. She required three additional doses over 22 hours. No bleeding or thrombotic events occurred, and the patient was discharged home without complications.Conclusion This case highlights the safe management of an epidural catheter in a parturient with severe factor VII deficiency.",
  "authors": [
    {
      "affiliations": [
        "Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Benjamin Hyers"
    },
    {
      "affiliations": [
        "Obstetrics, Gynecology, and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Camila Cabrera"
    },
    {
      "affiliations": [
        "The Mount Sinai Hemophilia Center, The Mount Sinai Hospital, New York, New York, USA"
      ],
      "name": "Christopher Walsh"
    },
    {
      "affiliations": [
        "Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Anusha Reddy"
    },
    {
      "affiliations": [
        "Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Talia Strulowitz"
    },
    {
      "affiliations": [
        "Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Joshua Hamburger"
    },
    {
      "affiliations": [
        "Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Nakiyah Knibbs"
    },
    {
      "affiliations": [
        "Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA",
        "Obstetrics, Gynecology, and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Daniel Katz"
    },
    {
      "affiliations": [
        "Obstetrics, Gynecology, and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Lauren Ferrara"
    },
    {
      "affiliations": [
        "Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA",
        "Obstetrics, Gynecology, and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Yaakov Beilin"
    }
  ],
  "title": "Anesthetic management with labor epidural analgesia of the parturient with severe factor VII deficiency: a case report",
  "uid": "05da2a75-abb8-5f08-92e4-b3139dd51c55"
}