Management of planned pregnancy in a patient with congenital antithrombin III deficiency.
Long-term warfarin therapy was changed to subcutaneous heparin to cover a planned pregnancy in a patient with congenital antithrombin III (AT III) deficiency. Satisfactory anticoagulation was easily maintained in spite of low levels of biologically active AT III. Delivery and the puerperium were covered by a reduced dose of heparin and alternate day infusions of AT III concentrate. A mean dose of 0.77 U/kg of AT III concentrate produced a rise of 1% in AT III and the half-life was of the order of 24 h, with no evidence of increased consumption during labour and delivery. Pregnancy and labour were uncomplicated and resulted in delivery of a healthy female infant. The importance of early and adequate anticoagulation during pregnancy is emphasized.
D000328:Adult; D000990:Antithrombin III / Q000008:administration & dosage; D020152:Antithrombin III Deficiency; D005260:Female; D005312:Fetal Blood / Q000032:analysis; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007123:Immunoelectrophoresis, Two-Dimensional; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000188:drug therapy*
D000990:Antithrombin III; D006493:Heparin