Argatroban therapy for heparin-induced thrombocytopenia during pregnancy in a woman with hereditary antithrombin deficiency

J Obstet Gynaecol Res. 2012 Apr;38(4):749-52. doi: 10.1111/j.1447-0756.2011.01758.x. Epub 2012 Mar 2.

Abstract

A 33-year-old woman developed deep venous thrombosis at 7 gestational weeks (GW). Heparin-induced thrombocytopenia was evident at 9 GW during unfractionated heparin infusion. Immediately, anticoagulation therapies together with antithrombin (AT) infusion were commenced with the use of argatroban from 9 GW, and fondaparinux was substituted for argatroban after 24 GW. The patient had hereditary AT deficiency type I determined by laboratory findings and results of genomic DNA analysis. The pregnancy ended in full-term vaginal delivery of a healthy male without adverse effects of the anticoagulation therapies. This was the first report of a pregnant woman who developed heparin-induced thrombocytopenia caused by heparin therapy for deep venous thrombosis due to AT deficiency.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / adverse effects*
  • Antithrombins / analysis*
  • Arginine / analogs & derivatives
  • Blood Coagulation Disorders, Inherited / complications*
  • Female
  • Heparin / adverse effects*
  • Humans
  • Male
  • Pipecolic Acids / therapeutic use*
  • Pregnancy
  • Pregnancy Complications, Hematologic / drug therapy*
  • Sulfonamides
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / drug therapy*
  • Venous Thrombosis / drug therapy*

Substances

  • Anticoagulants
  • Antithrombins
  • Pipecolic Acids
  • Sulfonamides
  • Heparin
  • Arginine
  • argatroban