Up to 70% of pregnant women with hereditary AT deficiency may experience thromboembolic complications1,2


PREGNANCY CASE STUDY: STEPHANIE

Age:28 years

Height5'4"

Weight154 lb (70 kg)



 

Family History: Peripheral artery disease, fatal massive pulmonary embolism, deep vein thrombosis, miscarriage

Chief Complaint: 39 weeks pregnant with AT deficiency and presents at hospital for induction of labor

Complication: Hereditary AT deficiency (AT activity 57% of normal)

Treatment Goals and Plan: To deliver a full-term infant, while preventing pregnancy-related venous thromboembolism (VTE) due to hereditary AT deficiency. AT activity will be increased to between 80% and 120% during the delivery. She will be administered THROMBATE III before administering regional anesthesia for pain relief. She will continue to receive THROMBATE III for 1 week postpartum to decrease the risk of VTE

 


THROMBATE III® (antithrombin III [human]) is indicated in patients with hereditary antithrombin deficiency for treatment and prevention of thromboembolism and for prevention of perioperative and peripartum thromboembolism.

Hypersensitivity reactions may occur. Should evidence of an acute hypersensitivity reaction be observed, promptly interrupt the infusion and begin appropriate treatment.

Because THROMBATE III is made from human blood, it may carry a risk of transmitting infectious agents, eg, viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent. There is also the possibility that unknown infectious agents may be present in the product.

Perform coagulation tests to avoid excessive or insufficient anticoagulation and monitor for bleeding or thrombosis. Measure functional plasma AT levels with amidolytic or clotting assays; do not use immunoassays.

In clinical studies, the most common adverse reactions (≥5% of subjects) were dizziness, chest discomfort, nausea, dysgeusia, and pain (cramps).

The anticoagulant effect of heparin is enhanced by concurrent treatment with THROMBATE III in patients with hereditary AT deficiency. Thus, in order to avoid bleeding, the dosage of heparin (or low molecular weight heparin) may need to be reduced during treatment with THROMBATE III.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.


References

  1. THROMBATE III® (antithrombin III [human]) Prescribing Information. Grifols.
  2. Hellgren M, Tengborn L, Abildgaard U. Pregnancy in women with congenital antithrombin III deficiency: experience of treatment with heparin and antithrombin. Gynecol Obstet Invest . 1982;14(2):127-141.