Two successful pregnancies following eight miscarriages in a patient with antithrombin deficiency.
Inherited thrombophilias are associated with an increased risk of maternal thromboembolism and certain adverse pregnancy outcomes, including second- and third-trimester fetal loss, placental abruption, severe intrauterine growth restriction, and early-onset, severe preeclampsia. Pregnant patients with severe thrombophilias, especially antithrombinopathies are at very high risk for both thromboembolism and adverse pregnancy outcomes. A case of a patient with antithrombin deficiency is reported, who had two successful pregnancies after eight miscarriages. Our case shows that a combined treatment with antithrombin substitution and a prophylactic, body-weight-adjusted dose of low-molecular-weight heparin may be successful in preventing pregnancy loss and thromboembolism in antithrombin deficiency during pregnancy, although other complications, such as preeclampsia and intrauterine growth restriction cannot always be prevented.
Szilágyi
A
A
Department of Obstetrics and Gynecology, University of Pécs, Pécs, Hungary. andras.szilagyi@aok.pte.hu
Nagy
A
A
Tamás
P
P
Vizer
M
M
Szabó
I
I
Losonczy
H
H
D000026:Abortion, Habitual / Q000517:prevention & control*; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D005337:Fibrin / Q000172:deficiency*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000235:genetics*; D013923:Thromboembolism / Q000235:genetics; D019851:Thrombophilia / Q000235:genetics; D016896:Treatment Outcome
D000925:Anticoagulants; D005337:Fibrin; D006493:Heparin