P-068 Gyneco-obstetrical bleeding in a cohort of female patients with factor XI deficiency. A report from French Canada

terms of pregnancy with threatened abortion. 1st pregnancy (2010) was complicated with repeated bleedings from esophagal and gastric varicose veins. At 20 weeks the patient was undergone urgent surgery (gastrotomy, phleborrhaphy of esophagal and gastric varicose veins). The diagnosis that was made was extrahepatic portal hypertension of thrombotic origin. Esophagal and gastric varicose veins bleeding Splenomegaly. Operation was complicated (subdiaphragmatic abscess with burst in the abdominal cavity, peritonitis, sepsis). At 24 weeks spontaneous abortion happened. The patient was urgently transferred to one of the Moscow clinics where she was reoperated and discharged in a satisfactory condition. On laboratory examination we detected HCV antibodies, Factor V Leiden mutation (+−) and polymorphisms of PAI-1 4G/5G, pro-inflammatory cytokines (IL-6, IL-1β, C-reactive protein). Homocystein level was normal.The antiphospholipid syndrome was excluded. At the moment of the address the patient received Sulodeksid, synthetic progesterone, folic acid. We took into account the medical history of the patient and the confirmed thrombophilic condition and corrected the treatment. We prescribed LMWH, natural micronized progesterone, vitamins, compression stockings. The pregnancy course was uncomplicated.At 39 weeks the patient had normal vaginal delivery, uncomplicated. We recommended to check the child for factor V Leiden mutation. In the postnatal period the treatment with LMWH was continued. Conclusion: The splanchnic vein thromboses are challenging. The clinical picture is various, and if the thrombophilic condition is undiagnosed the patient would remain in the risk group for postnatal portal hypertension.