Management of antithrombin III deficiency in pregnancy: a representative case and a literature review

The work is aimed at discussing pregnancy management for the most thrombogenic genetic thrombophilia - antithrombin III (AT-III) deficiency. A detailed analysis of the literature and clinical case of pregnancy management in a patient with AT-III deficiency, pulmonary embolism and habitual history of...

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Main Authors: S. V. Akinshina, P. K. Genina, V. O. Bitsadze, J. Kh. Khizroeva, V. I. Tsibizova, A. D. Makatsariya
Format: Article
Language:Russian
Published: IRBIS LLC 2021-09-01
Series:Акушерство, гинекология и репродукция
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Online Access:https://www.gynecology.su/jour/article/view/1072
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author S. V. Akinshina
P. K. Genina
V. O. Bitsadze
J. Kh. Khizroeva
V. I. Tsibizova
A. D. Makatsariya
author_facet S. V. Akinshina
P. K. Genina
V. O. Bitsadze
J. Kh. Khizroeva
V. I. Tsibizova
A. D. Makatsariya
author_sort S. V. Akinshina
collection DOAJ
description The work is aimed at discussing pregnancy management for the most thrombogenic genetic thrombophilia - antithrombin III (AT-III) deficiency. A detailed analysis of the literature and clinical case of pregnancy management in a patient with AT-III deficiency, pulmonary embolism and habitual history of miscarriage has been performed and presented. Patients with AT-III deficiency are at high risk for developing thrombotic and obstetric complications even despite using therapeutic doses of anticoagulants. Indications for use and modes of administration of AT-III concentrate have not been currently defined clearly. Monitoring therapy with low molecular weight heparin is largely complicated because a test for determining anti-Xa activity is AT-III-dependent. In addition to standard methods for controlling antithrombotic therapy, we used tests characterizing the dynamic blood clot parameters: thromboelastography and thrombin generation test. The peak risk resulting in both thrombotic and hemorrhagic complications in such patients occurs during period of labor and the postpartum period, when a change in the regimen of anticoagulant therapy is required with its temporary withdrawal and additional administration of AT-III concentrate.
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series Акушерство, гинекология и репродукция
spelling doaj-art-3fcfd617d6f04220847086d34c5e9fe52025-08-20T02:53:55ZrusIRBIS LLCАкушерство, гинекология и репродукция2313-73472500-31942021-09-0115444145010.17749/2313-7347/ob.gyn.rep.2021.230667Management of antithrombin III deficiency in pregnancy: a representative case and a literature reviewS. V. Akinshina0P. K. Genina1V. O. Bitsadze2J. Kh. Khizroeva3V. I. Tsibizova4A. D. Makatsariya5«Medical Centre for Women» LLCSechenov UniversitySechenov UniversitySechenov UniversityAlmazov National Medical Research Centre, Health Ministry of Russian FederationSechenov UniversityThe work is aimed at discussing pregnancy management for the most thrombogenic genetic thrombophilia - antithrombin III (AT-III) deficiency. A detailed analysis of the literature and clinical case of pregnancy management in a patient with AT-III deficiency, pulmonary embolism and habitual history of miscarriage has been performed and presented. Patients with AT-III deficiency are at high risk for developing thrombotic and obstetric complications even despite using therapeutic doses of anticoagulants. Indications for use and modes of administration of AT-III concentrate have not been currently defined clearly. Monitoring therapy with low molecular weight heparin is largely complicated because a test for determining anti-Xa activity is AT-III-dependent. In addition to standard methods for controlling antithrombotic therapy, we used tests characterizing the dynamic blood clot parameters: thromboelastography and thrombin generation test. The peak risk resulting in both thrombotic and hemorrhagic complications in such patients occurs during period of labor and the postpartum period, when a change in the regimen of anticoagulant therapy is required with its temporary withdrawal and additional administration of AT-III concentrate.https://www.gynecology.su/jour/article/view/1072antithrombin iii deficiencypregnancylow molecular weight heparinantithrombin iii concentraterivaroxaban
spellingShingle S. V. Akinshina
P. K. Genina
V. O. Bitsadze
J. Kh. Khizroeva
V. I. Tsibizova
A. D. Makatsariya
Management of antithrombin III deficiency in pregnancy: a representative case and a literature review
Акушерство, гинекология и репродукция
antithrombin iii deficiency
pregnancy
low molecular weight heparin
antithrombin iii concentrate
rivaroxaban
title Management of antithrombin III deficiency in pregnancy: a representative case and a literature review
title_full Management of antithrombin III deficiency in pregnancy: a representative case and a literature review
title_fullStr Management of antithrombin III deficiency in pregnancy: a representative case and a literature review
title_full_unstemmed Management of antithrombin III deficiency in pregnancy: a representative case and a literature review
title_short Management of antithrombin III deficiency in pregnancy: a representative case and a literature review
title_sort management of antithrombin iii deficiency in pregnancy a representative case and a literature review
topic antithrombin iii deficiency
pregnancy
low molecular weight heparin
antithrombin iii concentrate
rivaroxaban
url https://www.gynecology.su/jour/article/view/1072
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AT pkgenina managementofantithrombiniiideficiencyinpregnancyarepresentativecaseandaliteraturereview
AT vobitsadze managementofantithrombiniiideficiencyinpregnancyarepresentativecaseandaliteraturereview
AT jkhkhizroeva managementofantithrombiniiideficiencyinpregnancyarepresentativecaseandaliteraturereview
AT vitsibizova managementofantithrombiniiideficiencyinpregnancyarepresentativecaseandaliteraturereview
AT admakatsariya managementofantithrombiniiideficiencyinpregnancyarepresentativecaseandaliteraturereview