Which combination of clotting factors increases during pregnancy?

• A. I, VII, VIII, XI, X, XII
• B. II, V, IX
• C. I, II, III
• D. VII, IX, XI

Answer: (A)

During pregnancy the coagulation system shifts toward a procoagulant state to protect against heavy bleeding at delivery. The liver increases production of fibrinogen (factor I) and several clotting factors, especially VII, VIII, X, XI, and XII. This pattern of rising factors—fibrinogen along with these specific factors—reflects the typical pregnancy-associated hypercoagulable state. Other options don’t match this broad increase: they omit one or more of the factors that reliably rise, or include factors that don’t consistently rise in pregnancy. Clinically, this hypercoagulable state reduces postpartum hemorrhage risk but increases the potential for thromboembolism, which is an important consideration in inpatient antepartum care.