Congenital antithrombin III deficiency and pregnancy: a description of various pregnancy management options according to international data
Objective. To describe various pregnancy management options according to international data in patients with congenital antithrombin (AT) III deficiency and venous thromboses occurring during pregnancy. Taking into account that the anticoagulant potential cannot be fully achieved using heparins/low-molecular-weight heparins (LMWH) alone, the authors consider other therapy approaches.Kirsanova T.V., Vinogradova M.A., Klimenchenko N.I.
Case report. The authors describe their own cases of AT III deficiency in young patients whose pregnancy has become a trigger for thrombosis; the course and outcome of pregnancies have been investigated; approaches to treating LMWH refractory thrombosis are depicted.
Conclusion. AT deficiency is a rare high-risk thrombophilia. Despite the use of adequate LMWH doses during pregnancy and the postpartum period, the women with AT deficiency remain prone to venous thrombosis/thromboembolism development or progression. There are limited and rather disparate descriptions of treatment for thrombotic events during pregnancy, including the use of antithrombin concentrates. The article summarizes current management approaches for these patients with special attention to the interdisciplinary approach.
Keywords
trombophilia
antithrombin III
treatment
pregnancy and the postpartum period
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Received 27.02.2018
Accepted 02.03.2018
About the Authors
Kirsanova, Tatyana V., PhD, senior researcher of the Department of Reproductive Hematology and Clinical Hemostasis, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79262484560. E-mail: A_Tatya@mail.ruVinogradova, Maria A., PhD, head of the Department of Reproductive Hematology and Clinical Hemostasiology, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954387135. E-mail: mary-grape@ya.ru
Klimenchenko, Natalia I., PhD, senior researcher Department of Pregnancy Pathology, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954387135. E-mail: n_klimenchenko@oparina4.ru
For citations: Kirsanova T.V., Vinogradova M.A., Klimenchenko N.I. Congenital antithrombin III deficiency and pregnancy: a description of various pregnancy management options according to international data. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (1): 171-77. (in Russian)
http://dx.doi.org/10.18565/aig.2019.1.171-177
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