Treatment of Homozygous Type II Antithrombin Heparin-Binding Site Deficiency in Pregnancy. (3rd September 2021)

• Record Type: Journal Article
• Authors: Fiskvik, Hilde; Jacobsen, Anne F.; Iversen, Nina; Henriksson, Carola E.; Jacobsen, Eva-Marie
• Other Names: Geisler John P. Academic Editor.
• Is Part Of: Case reports in obstetrics and gynecology. Volume 2021(2021)
• Publication Date: 2021-09-03
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; Generative organs, Female -- Diseases -- Periodicals; Obstetrics; Gynecology; Genital Diseases, Female; Generative organs, Female -- Diseases; Gynecology; Obstetrics; Electronic journals; Periodicals; Periodicals; 618
• DOI: 10.1155/2021/4393821
• Languages: English
• ISSNs: 2090-6684

Abstract

Abstract : Pregnancy is associated with an increased risk of venous thromboembolism (VTE). Previous VTE and severe thrombophilia are important risk factors. Our case was a 36-year-old woman, gravida 6, para 0, with antithrombin (AT) deficiency caused by a homozygous mutation in the heparin-binding site (HBS). Her history included seven prior VTEs, three early and two late pregnancy losses. She was prophylactically treated with both human plasma-derived AT concentrate (hpATC) and low molecular weight heparin (LMWH), resulting in a successful 6 th pregnancy and a healthy live born baby. There is limited evidence and guidance on the management of AT deficiency in pregnancy. Dosing and monitoring of anticoagulants, alone or together with hpATC, must be based on individual risk assessment. The severity of clinical manifestations varies with the type of AT deficiency. Characterization of the AT mutation may aid in the decision-making process and optimize pregnancy outcomes.