Case Report
Management of Venous Thromboembolism in Patients with Hereditary Antithrombin Deficiency and Pregnancy: Case Report and Review of the Literature
Table 1
Family History of venous thromboembolic events of the index case.
| Relationship | Age at diagnosis | Type of AT deficiency | Other inherited or acquired risk factors | History of VTE | Management | Outcome |
| Mother | 50 | 1 | Smoking | DVT-PE | N/A | VTE resolved |
| Sister 1 | 18 | 1 | Postpartum at time of death | Fatal PE | N/A | Fatal |
| Sister 2 | 25 | 1 | Pregnant at time of VTE | Cerebral vein thrombosis | LMWH + AT concentrate | VTE resolved, successful delivery at 34 weeks |
| Index case | 22 | 1 | None | DVT & PE at age of 25
| Warfarin until age of 36
| Developed amaurosis fugax, switched to rivaroxaban | DVT during pregnancy at age 37 | Initially on tinzaparin (for pregnancy) but switched to dalteparin and AT concentrate | Miscarriage at GW 7, received D & C after which continued warfarin and AT concentrate × 6 weeks |
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AT: antithrombin, D & C: dilatation and curettage, DVT: deep vein thrombosis, gw: gestational week, LMWH: low molecular weight heparin, and PE: pulmonary embolus.
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