Management and outcome of pregnancies in women with antithrombin deficiency: A single-center experience and review of literature

Péter Ilonczai, Zsolt Oláh, Anna Selmeczi, Adrienne Kerényi, Z. Bereczky, Róbert Póka, Ágota Schlammadinger, Z. Boda

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Women with antithrombin (AT) deficiency have an increased risk for pregnancy-associated venous thromboembolism (VTE) and adverse pregnancy outcome. AT deficiency is a rare thrombophilia with heterogeneous genetic background. Owing to the few cases reported in the literature, management strategies of pregnancy with AT deficiency are inconsistent. Our aim was to examine the type of the genetic defect, management, maternal, and pregnancy outcome in patients with hereditary AT deficiency. Five expectant mothers with AT deficiency were followed in our center to evaluate thrombotic events, and maternal and pregnancy outcomes. AT gene sequencing was performed in all cases, and levels of AT and anti-activated factor X were regularly measured to guide the risk-adopted anticoagulant prophylaxis. Three mothers had homozygous type II heparin-binding site mutations and two had heterozygous type I mutations of the gene encoding AT. Two women had additional factor V Leiden heterozygous mutations. Three maternal VTEs-four healthy newborns and five pregnancy losses-were observed. The risk of patients to VTE and adverse pregnancy outcome was found to associate with the homozygous type II heparin-binding site mutation of the AT gene. High risk of maternal VTE and frequent pregnancy complications were observed to associate with AT deficiency. Our results support the need of individualized, risk-adopted anticoagulant therapy in patients with AT deficiency.

Original languageEnglish
Pages (from-to)798-804
Number of pages7
JournalBlood Coagulation and Fibrinolysis
Volume26
Issue number7
DOIs
Publication statusPublished - Jan 1 2015

Fingerprint

Antithrombins
Pregnancy Outcome
Mothers
Venous Thromboembolism
Mutation
Pregnancy
Anticoagulants
Heparin
Antithrombin III Deficiency
Binding Sites
Genes
Factor Xa
Thrombophilia
Pregnancy Complications
Newborn Infant

Keywords

  • anticoagulant therapy
  • antithrombin concentrate
  • antithrombin deficiency
  • pregnancy

ASJC Scopus subject areas

  • Hematology

Cite this

Management and outcome of pregnancies in women with antithrombin deficiency : A single-center experience and review of literature. / Ilonczai, Péter; Oláh, Zsolt; Selmeczi, Anna; Kerényi, Adrienne; Bereczky, Z.; Póka, Róbert; Schlammadinger, Ágota; Boda, Z.

In: Blood Coagulation and Fibrinolysis, Vol. 26, No. 7, 01.01.2015, p. 798-804.

Research output: Contribution to journalArticle

Ilonczai, Péter ; Oláh, Zsolt ; Selmeczi, Anna ; Kerényi, Adrienne ; Bereczky, Z. ; Póka, Róbert ; Schlammadinger, Ágota ; Boda, Z. / Management and outcome of pregnancies in women with antithrombin deficiency : A single-center experience and review of literature. In: Blood Coagulation and Fibrinolysis. 2015 ; Vol. 26, No. 7. pp. 798-804.
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