81. Presentation of Factor VII Deficiency Secondary to Prolonged Post-abortal Bleeding

Abstract

Abnormal uterine bleeding (AUB) is a common gynecologic referral for an adolescent. Recommendations for bleeding disorder (BD) evaluation include heavy menstrual bleeding (HMB) since menarche, postpartum hemorrhage and surgery or dental procedure related bleeding. Minor symptoms include frequent bruising, gum bleeding, epistaxis and suggestive family history. Up to 20% of adolescents who require hospitalization for HMB have an underlying BD. Although guidelines addressing who to screen are helpful, less severe BD may present only with more significant bleeding challenges outside of the aforementioned criteria, including miscarriage. We report an atypical presentation of a BD in a 15 year old with recent medical management of a missed abortion in whom factor VII deficiency was diagnosed after prolonged and HMB following passage of products of conception (POC).