Management of Neuraxial Analgesia in a Parturient with Factor XIII Deficiency: A Case Report and Proposed Management Algorithm

Figure 1

Algorithm for performing neuraxial procedures in patients with FXIII deficiency. VET: viscoelastic testing. ¹FXIII activity may be known by quantitative testing on admission, or calculated by a hematologist, taking into consideration patient’s medical conditions, comorbidities, timing of last dose, and quantitative assessment of prior response during the 3^rd trimester. ²Administration of FXIII may be necessary because of the time required to obtain results of a quantitative FXIII test. FXIII dosing should be based on the recommendation of the hematologist, targeting level above 50%. ³FXIII also confirmed or calculated above 50% for epidural catheter removal.