A case of a combined commonly inherited bleeding and clotting disorder.

A 30-year-old woman was referred for screening for an inherited thrombophilia. Her brother had developed a lifethreatening deep-vein thrombosis after a mild sports injury. A noteworthy finding on personal history was easy bruising. Thrombotic screen testing revealed a heterozygous factor V Leiden mutation and a bleeding screen type I von Willebrand disease (vWD). She later presented at 12 weeks’ gestation with her first pregnancy. Factor VIII, von Willebrand factor (VWF) antigen and activity levels measured at presentation and in the third trimester were in the normal range. Thromboprophylaxis with enoxaparin 20 mg daily (weight 56 kg) was prescribed from 32 weeks’ gestation until 4 weeks before delivery. AntiXa activity and platelet counts were monitored. She went into preterm labour and delivered a male baby by caesarean section.