FACTOR-V DEFICIENCY AND MENSTRUATION - A GYNECOLOGIC CHALLENGE

Background: Menorrhagia is a well-known complication of factor V defic iency. Case: A 13-year-old girl with factor V deficiency presented wit h acute hemorrhage on day 4 of menses. Laboratory assessment revealed a hemoglobin of 36 g/L. The ultrasound appearance of a large loculated cystic mass was consistent with substantial intraperitoneal bleeding. Stabilization with blood products was followed by GnRH agonist therap y. Medical management was instituted effectively. Continued compliance with medication is essential to prevent recurrences. Conclusion: Fact or V deficiency is rare. Coagulation disorders of this nature pose a c hallenge to gynecologists involved in patient management at the time o f menses. (C) 1997 by The American College of Obstetricians and Gyneco logists.