Key result
Treatment with 55,000 IU of subcutaneous heparin daily from the 15th to 36th week of pregnancy resulted in a successful vaginal delivery with no clinical complications during the puerperal period.
Why the study?
Does subcutaneous heparin prevent thrombotic complications in a pregnant woman with MTHFR mutation and anticardiolipin antibodies?
Case Report (n=1)
Does subcutaneous heparin prevent thrombotic complications in a pregnant woman with MTHFR mutation and anticardiolipin antibodies?
Subcutaneous heparin successfully prevented thrombotic complications during pregnancy and the puerperal period in a high-risk patient with MTHFR mutation and anticardiolipin antibodies.
Answers are grounded in this paper and cite their sources.
May support individualized heparin in high-risk MTHFR/anticardiolipin pregnancies; hypothesis-generating, requires prospective trials before adoption.
CONTEXT: High plasmatic homocysteine levels have been associated with arterial and venous thrombosis. The C677T methylene tetrahydrofolate reductase (MTHFR) gene mutation is one of the known causes for high homocysteine levels in plasma. Anticardiolipin antibody (ACA) is also associated with thrombosis and, along with other clinical complications such as recurrent abortion and stillbirth, is part of the antiphospholipid syndrome. DESIGN: Case report. CASE REPORT: A 19-year-old woman with two gestations and one parity (G2P1) had exhibited deep venous thrombosis in her previous puerperal period. Investigation of thrombophilic factors revealed ACA-IgM and heterozygous C677T mutation in the MTHFR gene. Lupus anticoagulant, protein C, protein S and antithrombin III deficiencies, and Leiden factor V and the G20210A mutation in the prothrombin gene, were not detected. The patient received 55,000 IU of subcutaneous heparin daily, from the 15th to the 36th week of pregnancy, when vaginal delivery took place. There were no clinical complications during the puerperal period and she was discharged three days after delivery, while still using oral anticoagulants.
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Couto et al. (2002) conducted a case report in Pregnancy with history of deep venous thrombosis, ACA-IgM, and heterozygous C677T MTHFR mutation (n=1). Subcutaneous heparin was evaluated on Clinical complications during puerperal period. Treatment with 55,000 IU of subcutaneous heparin daily from the 15th to 36th week of pregnancy resulted in a successful vaginal delivery with no clinical complications during the puerperal period.
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