<s>[INST] Hi doctor, My wife is 34 year old. Her INR is 3.34 and blood factor VII activity test showed less than 2%. Her CT and BT are normal. She has been advised to undergo gallbladder removal. With same condition, she had given birth to two babies through normal delivery (second one was 1 and 1/2 years back). Recently, she had a tooth extraction without any extra bleeding. Kindly suggest the safe way to undergo surgery. [/INST] Hi. Based on your query, my opinion is as follows: Repeat INR before surgery. For further queries consult a hematologist online.---> </s>