Why the study?
Does subcutaneous heparin and AT III concentrate safely maintain anticoagulation and prevent complications in a pregnant patient with congenital AT III deficiency?
Does subcutaneous heparin and AT III concentrate safely maintain anticoagulation and prevent complications in a pregnant patient with congenital AT III deficiency?
Subcutaneous heparin combined with AT III concentrate during delivery safely and effectively manages anticoagulation in pregnant patients with congenital AT III deficiency.
Answers are grounded in this paper and cite their sources.
May support AT III dosing in pregnant congenital deficiency; leaves open prospective validation before practice change.
Long-term warfarin therapy was changed to subcutaneous heparin to cover a planned pregnancy in a patient with congenital antithrombin III (AT III) deficiency. Satisfactory anticoagulation was easily maintained in spite of low levels of biologically active AT III. Delivery and the puerperium were covered by a reduced dose of heparin and alternate day infusions of AT III concentrate. A mean dose of 0.77 U/kg of AT III concentrate produced a rise of 1% in AT III and the half-life was of the order of 24 h, with no evidence of increased consumption during labour and delivery. Pregnancy and labour were uncomplicated and resulted in delivery of a healthy female infant. The importance of early and adequate anticoagulation during pregnancy is emphasized.
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Samson et al. (1984) studied this question.
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