Treatment of Homozygous Type II Antithrombin Heparin-Binding Site Deficiency in Pregnancy

Pregnancy is associated with an increased risk of venous thromboembolism (VTE). Previous VTE and severe thrombophilia are important risk factors. Our case was a 36-year-old woman, gravida 6, para 0, with antithrombin (AT) deficiency caused by a homozygous mutation in the heparin-binding site (HBS)....

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Main Authors: Hilde Fiskvik, Anne F. Jacobsen, Nina Iversen, Carola E. Henriksson, Eva-Marie Jacobsen
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2021/4393821
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author Hilde Fiskvik
Anne F. Jacobsen
Nina Iversen
Carola E. Henriksson
Eva-Marie Jacobsen
author_facet Hilde Fiskvik
Anne F. Jacobsen
Nina Iversen
Carola E. Henriksson
Eva-Marie Jacobsen
author_sort Hilde Fiskvik
collection DOAJ
description Pregnancy is associated with an increased risk of venous thromboembolism (VTE). Previous VTE and severe thrombophilia are important risk factors. Our case was a 36-year-old woman, gravida 6, para 0, with antithrombin (AT) deficiency caused by a homozygous mutation in the heparin-binding site (HBS). Her history included seven prior VTEs, three early and two late pregnancy losses. She was prophylactically treated with both human plasma-derived AT concentrate (hpATC) and low molecular weight heparin (LMWH), resulting in a successful 6th pregnancy and a healthy live born baby. There is limited evidence and guidance on the management of AT deficiency in pregnancy. Dosing and monitoring of anticoagulants, alone or together with hpATC, must be based on individual risk assessment. The severity of clinical manifestations varies with the type of AT deficiency. Characterization of the AT mutation may aid in the decision-making process and optimize pregnancy outcomes.
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series Case Reports in Obstetrics and Gynecology
spelling doaj-art-7e55ef0be70a481d98aa98cef64928532025-02-03T01:27:24ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922021-01-01202110.1155/2021/43938214393821Treatment of Homozygous Type II Antithrombin Heparin-Binding Site Deficiency in PregnancyHilde Fiskvik0Anne F. Jacobsen1Nina Iversen2Carola E. Henriksson3Eva-Marie Jacobsen4Department of Hematology, Oslo University Hospital, Oslo, NorwayDepartment of Obstetrics and Gynecology, Oslo University Hospital, Oslo, NorwayDepartment of Medical Genetics, Oslo University Hospital, Oslo, NorwayInstitute of Clinical Medicine, University of Oslo, NorwayDepartment of Hematology, Oslo University Hospital, Oslo, NorwayPregnancy is associated with an increased risk of venous thromboembolism (VTE). Previous VTE and severe thrombophilia are important risk factors. Our case was a 36-year-old woman, gravida 6, para 0, with antithrombin (AT) deficiency caused by a homozygous mutation in the heparin-binding site (HBS). Her history included seven prior VTEs, three early and two late pregnancy losses. She was prophylactically treated with both human plasma-derived AT concentrate (hpATC) and low molecular weight heparin (LMWH), resulting in a successful 6th pregnancy and a healthy live born baby. There is limited evidence and guidance on the management of AT deficiency in pregnancy. Dosing and monitoring of anticoagulants, alone or together with hpATC, must be based on individual risk assessment. The severity of clinical manifestations varies with the type of AT deficiency. Characterization of the AT mutation may aid in the decision-making process and optimize pregnancy outcomes.http://dx.doi.org/10.1155/2021/4393821
spellingShingle Hilde Fiskvik
Anne F. Jacobsen
Nina Iversen
Carola E. Henriksson
Eva-Marie Jacobsen
Treatment of Homozygous Type II Antithrombin Heparin-Binding Site Deficiency in Pregnancy
Case Reports in Obstetrics and Gynecology
title Treatment of Homozygous Type II Antithrombin Heparin-Binding Site Deficiency in Pregnancy
title_full Treatment of Homozygous Type II Antithrombin Heparin-Binding Site Deficiency in Pregnancy
title_fullStr Treatment of Homozygous Type II Antithrombin Heparin-Binding Site Deficiency in Pregnancy
title_full_unstemmed Treatment of Homozygous Type II Antithrombin Heparin-Binding Site Deficiency in Pregnancy
title_short Treatment of Homozygous Type II Antithrombin Heparin-Binding Site Deficiency in Pregnancy
title_sort treatment of homozygous type ii antithrombin heparin binding site deficiency in pregnancy
url http://dx.doi.org/10.1155/2021/4393821
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