# Acquired factor VIII deficiency in a nulliparous patient undergoing induction of labor

## TL;DR

A 31-year-old woman developed acquired factor VIII deficiency during labor, leading to severe bleeding complications and requiring specialized treatment.

## Contribution

This case highlights the rare occurrence and management challenges of acquired factor VIII deficiency during labor.

## Key findings

- The patient experienced complications including epidural hematoma and prolonged surgical site bleeding.
- Treatment involved blood products, human Factor VII, rituximab, and steroids.
- Acquired factor VIII deficiency should be considered in patients with prolonged aPTT and bleeding.

## Abstract

To present a case of acquired factor VIII deficiency in the setting of labor and describe the challenges of its diagnosis and treatment.

A 31-year-old woman was diagnosed with acquired factor VIII deficiency while undergoing induction of labor. Her labor and post operative course were complicated by epidural hematoma formation, prolonged postoperative surgical site bleeding, and subcutaneous hematoma. Management included blood products, human Factor VII, rituximab, and a steroid taper.

Acquired factor VIII deficiency can be challenging to diagnose and should be considered in the differential diagnosis in patients with prolonged bleeding accompanied by a prolonged activated partial thromboplastin time (aPTT).