A 6-Hour-Old Boy Is Evaluated in the Newborn Nursery Due

A 6-hour-old boy is evaluated in the newborn nursery due to scalp swelling.  The patient was born at term via cesarean delivery to a 21-year-old primigravida.  The pregnancy was unremarkable, and the mother's only medication was a prenatal multivitamin.  Delivery was complicated by 18 hours of active labor followed by arrest of descent, necessitating cesarean delivery.  Family history is notable for a maternal uncle with severe hemophilia A.  Temperature is 37.3 C (99.1 F) and pulse is 190/min.  The patient appears pale.  Examination of the scalp shows diffuse, fluctuant edema extending from the right ear across the vertex to just above the left ear.  Laboratory results are as follows: Which of the following is the most likely cause of this patient's clinical presentation?

A) Absent coagulation factor carboxylation
B) Factor VIII deficiency
C) Massive coagulation factor consumption
D) Subgaleal vein shearing
E) Subperiosteal vessel rupture

Correct Answer:

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