The intrapartum use of antithrombin III in an antithrombin III-deficient patient: a case report and review of the literature

Background: Antithrombin III deficiency is an inherited thrombophilia that places pregnant patients at an increased risk of venous thromboembolism and adverse outcomes in pregnancy. Antithrombin III-deficient patients undergoing obstetric procedures may benefit from antithrombin III infusions during labor and delivery. Case: The patient is a 32-year-old G2P1000 with known antithrombin III deficiency and factor V Leiden heterozygosity with a prior intrauterine fetal demise. The patient was managed with therapeutic enoxaparin until 37 weeks’ gestation when she was changed to IV heparin and plasma-derived antithrombin III. She underwent successful induction of labor, epidural anesthesia, and had an uncomplicated vaginal delivery. Conclusion: Plasma-derived antithrombin III can be used intrapartum for successful delivery in a patient with antithrombin III deficiency.