Key result
Antithrombin concentrate maintains AT activity >50% in pregnancy-induced deficiency, enabling safe delivery timing.
Why the study?
Pregnancy-induced isolated anti-thrombin deficiency without other abnormalities such as hypertension or proteinuria is a rare clinical occurrence requiring further characterization.
Case Report (n=1)
Pregnancy-induced anti-thrombin deficiency can occur in isolation, and monitoring its activity may assist in determining the appropriate timing for delivery.
Answers are grounded in this paper and cite their sources.
May guide delivery timing in isolated pregnancy-induced AT deficiency; leaves open prospective validation before practice change.
A woman with twin pregnancy had a gradual decline in anti‐thrombin (AT) activity from 72% at gestational week (GW) 29–3/7, to 53% at GW31–2/7, and to 41% at GW32–2/7, at which time hypertension (148/90 mmHg) and proteinuria (protein‐to‐creatinine ratio [P/Cr], 0.79 mg/mg) developed in the presence of normal platelet count (159 × 109/L) and serum aspartate aminotransferase/lactate dehydrogenase (22/164 IU/L). AT product was given three times to maintain AT activity >50% and blood pressure was maintained below 155/95 mmHg with no treatment, but generalized edema with a weekly weight gain of 4.9 kg and increased proteinuria (to P/Cr, 7.6 mg/mg) required cesarean section at GW33–3/7. This case highlights the occurrence of pregnancy‐induced AT deficiency alone in the absence of any other abnormality, including hypertension, proteinuria, or thrombocytopenia. Measurement of AT activity was considered helpful for determination of the appropriate time for delivery in this patient.
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Kawabata et al. (2016) conducted a case report in Pregnancy-induced anti-thrombin deficiency (n=1). Anti-thrombin (AT) product was evaluated. Administration of anti-thrombin product maintained AT activity >50% in a woman with twin pregnancy and isolated pregnancy-induced AT deficiency, allowing determination of appropriate delivery time.
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