A 36-yr-old pregnant woman with
blood coagulation factor XII deficiency was scheduled to undergo
cesarean section. Preoperative blood coagulation scan revealed prolonged activated partial thrombin time of 105.6 s (control, 30.3 s), and a decrease in
factor XII level of 3% (normal; 70-120%). Other examinations such as prothrombin time, platelet count and bleeding time were within normal limits. But she reported no history of
bleeding. Before the operation, we discussed with obstetricians whether fresh frozen plasma (FFP) should be administered, or not. According to a report, a patient with
factor XII deficiency can undergo major surgery without plasma replacement
therapy. But another study showed that 15-30% of the
factor XII activity was needed for hemostasis. We, therefore, administered 4 units of fresh frozen plasma before the operation. The operation was performed with
general anesthesia uneventfully. Generally, a patient with
factor XII deficiency has no clinical
bleeding problems and unnecessary FFP administration may cause
infection. Therefore it is not necessary to administer FFP to this patient.