Pregnancy complicated with antithrombin Ⅲ deficiency: a case report and literature review
李桃英 1王赛赛 1周明丽 1张梓然 1朱宝菊1
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作者信息
1. 郑州大学第二附属医院产科，郑州 450000
折叠
摘要
目的 报道1例妊娠合并抗凝血酶（antithrombin，AT）Ⅲ缺乏症孕妇的诊断和治疗，结合文献梳理诊治思路。 方法 回顾2023年10月至2024年6月郑州大学第二附属医院收治的1例AT-Ⅲ缺乏症孕妇的临床诊治过程，并结合相关文献，总结妊娠合并AT-Ⅲ缺乏症对妊娠结局的影响，并为抗凝方案的制定提供参考。 结果 患者有3次不良孕产史及双下肢深静脉血栓史，本次妊娠期AT活性波动于34%~50%，孕期共输新鲜冰冻血浆3次，孕前开始使用低分子肝素至分娩前24 h，孕中期加用华法林、羟氯喹、环孢素及甲泼尼龙，孕35周终止妊娠，胎儿出生体重2 330 g，早产儿转入儿科治疗14 d出院，随访至今未发现异常。 结论 对妊娠合并AT-Ⅲ缺乏症给予精准治疗可有效改善妊娠结局。 Objective To report the diagnosis and treatment of a pregnant woman with antithrombin (AT) Ⅲ deficiency in pregnancy, and combine the diagnosis and treatment ideas with the literature. Methods The clinical diagnosis and treatment process of one pregnant woman with AT-Ⅲ deficiency admitted to the Second Affiliated Hospital of Zhengzhou University from October 2023 to June 2024 were retrospectively analyzed. Combined with relevant literature, the effect of pregnancy with AT-Ⅲ deficiency on pregnancy outcome was summarized, and reference was provided for the formulation of anticoagulant regimen. Results The patient had 3 adverse pregnancy histories and a deep venous thrombosis of the lower limbs. The AT activity fluctuated between 34% and 50% during this pregnancy. The patient received 3 transfusions of fresh frozen plasma during pregnancy and was administered low molecular weight heparin from pre-pregnancy until 24 hours before delivery. Warfarin, hydroxychloroquine, cyclosporine and methylprednisolone were added in the second trimester. The pregnancy was terminated at 35 weeks of gestation. The infant was born with a weight of 2,330 g and was transferred to the pediatric department for treatment. After 14 days, the infant was discharged. Follow-up to date has not revealed any abnormalities. Conclusion Precise treatment of pregnancy with AT-Ⅲ deficiency can effectively improve pregnancy outcomes.
Abstract
Objective To report the diagnosis and treatment of a pregnant woman with antithrombin (AT) Ⅲ deficiency in pregnancy, and combine the diagnosis and treatment ideas with the literature. Methods The clinical diagnosis and treatment process of one pregnant woman with AT-Ⅲ deficiency admitted to the Second Affiliated Hospital of Zhengzhou University from October 2023 to June 2024 were retrospectively analyzed. Combined with relevant literature, the effect of pregnancy with AT-Ⅲ deficiency on pregnancy outcome was summarized, and reference was provided for the formulation of anticoagulant regimen. Results The patient had 3 adverse pregnancy histories and a deep venous thrombosis of the lower limbs. The AT activity fluctuated between 34% and 50% during this pregnancy. The patient received 3 transfusions of fresh frozen plasma during pregnancy and was administered low molecular weight heparin from pre-pregnancy until 24 hours before delivery. Warfarin, hydroxychloroquine, cyclosporine and methylprednisolone were added in the second trimester. The pregnancy was terminated at 35 weeks of gestation. The infant was born with a weight of 2,330 g and was transferred to the pediatric department for treatment. After 14 days, the infant was discharged. Follow-up to date has not revealed any abnormalities. Conclusion Precise treatment of pregnancy with AT-Ⅲ deficiency can effectively improve pregnancy outcomes.
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