A case that illustrates the challenges of managing pregnant patients with antithrombin deficiency: More questions than answers.
Thromb Res
; 157: 1-6, 2017 Sep.
Article
in En
| MEDLINE
| ID: mdl-28667866
ABSTRACT
Using an illustrative case of a patient with antithrombin (AT) deficiency who developed a recurrent venous thromboembolism (VTE) in pregnancy despite therapeutic low-molecular-weight heparin (LMWH), we highlight what is known in the literature and address areas of controversy through a series of questions around the case. The questions we address include the role of anti-Xa monitoring for patients with past VTE on antepartum LMWH, what treatment regimen is recommended for pregnant patients who develop a recurrent VTE while on therapeutic anticoagulation, the role of antepartum AT concentrate prophylaxis, and the management of labor/delivery, epidural anesthesia and postpartum anticoagulation. We also describe practical considerations for use of AT concentrate, including teaching our patient to self-infuse AT concentrate at home with support of a hemophilia treatment center (HTC), and the direct and indirect costs of AT concentrate for secondary prophylaxis.
Key words
Full text:
1
Database:
MEDLINE
Main subject:
Antithrombin III Deficiency
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Language:
En
Year:
2017
Type:
Article