For an asymptomatic patient discovered during workup for elevated PT/PTT to have mild prothrombin deficiency, would you suggest any preoperative prophylaxis?
Level >60%. No family or surgical h/o of bleeding but heavy postpartum bleeding.
2 Answers
Mednet MemberInvited Expert
Pediatric Hematology/Oncology · St. Jude Children’s Research Hospital
Answered on
In someone with normal liver function otherwise, who was found on preoperative screening to have both mildly prolonged PT and PTT, AND the only abnormality found was a factor II (2, prothrombin) level >60%, I would not administer preoperative prophylaxis. However, I find the question confusing as it...
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Mednet MemberInvited Expert
Hematology · Former Assistant Chief of the Hematology Branch
Answered on
The generally accepted hemostatic level for prothrombin is 40%. It is doubtful that the 40% level is the cause of her past bleeding or a cause of the prolonged PT and PTT. I'm assuming that a mixing study showed a correction of the level and that her lupus anticoagulant is negative.
- A bleeding asse...
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