Thrombin Generation Decrease After LMWH Administration in an Antithrombin-Deficient Pregnant Woman With a Homozygous HBS II Mutation
The cases of antithrombin (AT)-deficient pregnant women with a homozygous HBS II mutation are relatively rare and are accompanied by an increased thrombophilic risk, which is manifested by increased thrombin generation (TG). It is very difficult to ensure their prophylactic treatment during pregnanc...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-09-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296231197174 |
| _version_ | 1827823175938867200 |
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| author | Ivana Malikova MS Martina Husakova MS Jana Bilkova MS Radka Brzezkova MD Ingrid Hrachovinova PhD Tomas Kvasnicka MD |
| author_facet | Ivana Malikova MS Martina Husakova MS Jana Bilkova MS Radka Brzezkova MD Ingrid Hrachovinova PhD Tomas Kvasnicka MD |
| author_sort | Ivana Malikova MS |
| collection | DOAJ |
| description | The cases of antithrombin (AT)-deficient pregnant women with a homozygous HBS II mutation are relatively rare and are accompanied by an increased thrombophilic risk, which is manifested by increased thrombin generation (TG). It is very difficult to ensure their prophylactic treatment during pregnancy. We aimed to determine the utility of the thrombin generation assay (TGA) and anti-factor Xa (anti-FXa) test to monitor the effects of a prophylactic dose of low-molecular-weight heparin (LMWH) in a 28-year-old woman with homozygous AT deficiency caused by mutation c.391C > T#, (p.Leu131Phe†) in the SERPINC1 gene and to compare the findings with those from a group of pregnant and non-pregnant women also treated with LMWH. TG monitoring was chosen due to severe AT deficiency that was manifested by low levels of anti-FXa activity when monitoring the efficacy of LMWH treatment. A significant decrease in TG was detected in all monitored groups ( P < .05). There were no thrombotic complications during the whole pregnancy of the woman with AT deficiency. Consistent monitoring of TG with LMWH anticoagulant therapy administration during pregnancy together with AT administration before and after delivery may improve the overall condition of pregnant women and the quality of their care. |
| first_indexed | 2024-03-12T02:07:24Z |
| format | Article |
| id | doaj.art-a1fc6e658ab1446589bc4b0d210b5fb1 |
| institution | Directory Open Access Journal |
| issn | 1938-2723 |
| language | English |
| last_indexed | 2024-03-12T02:07:24Z |
| publishDate | 2023-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj.art-a1fc6e658ab1446589bc4b0d210b5fb12023-09-07T01:33:22ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232023-09-012910.1177/10760296231197174Thrombin Generation Decrease After LMWH Administration in an Antithrombin-Deficient Pregnant Woman With a Homozygous HBS II MutationIvana Malikova MS0Martina Husakova MS1Jana Bilkova MS2Radka Brzezkova MD3Ingrid Hrachovinova PhD4Tomas Kvasnicka MD5 Central Hematological Laboratory, General University Hospital and Charles University First Faculty of Medicine, Prague, Czech Republic Central Hematological Laboratory, General University Hospital and Charles University First Faculty of Medicine, Prague, Czech Republic Thrombotic Centre of Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and Charles University First Faculty of Medicine, Prague, Czech Republic Thrombotic Centre of Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and Charles University First Faculty of Medicine, Prague, Czech Republic , Prague, Czech Republic Thrombotic Centre of Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and Charles University First Faculty of Medicine, Prague, Czech RepublicThe cases of antithrombin (AT)-deficient pregnant women with a homozygous HBS II mutation are relatively rare and are accompanied by an increased thrombophilic risk, which is manifested by increased thrombin generation (TG). It is very difficult to ensure their prophylactic treatment during pregnancy. We aimed to determine the utility of the thrombin generation assay (TGA) and anti-factor Xa (anti-FXa) test to monitor the effects of a prophylactic dose of low-molecular-weight heparin (LMWH) in a 28-year-old woman with homozygous AT deficiency caused by mutation c.391C > T#, (p.Leu131Phe†) in the SERPINC1 gene and to compare the findings with those from a group of pregnant and non-pregnant women also treated with LMWH. TG monitoring was chosen due to severe AT deficiency that was manifested by low levels of anti-FXa activity when monitoring the efficacy of LMWH treatment. A significant decrease in TG was detected in all monitored groups ( P < .05). There were no thrombotic complications during the whole pregnancy of the woman with AT deficiency. Consistent monitoring of TG with LMWH anticoagulant therapy administration during pregnancy together with AT administration before and after delivery may improve the overall condition of pregnant women and the quality of their care.https://doi.org/10.1177/10760296231197174 |
| spellingShingle | Ivana Malikova MS Martina Husakova MS Jana Bilkova MS Radka Brzezkova MD Ingrid Hrachovinova PhD Tomas Kvasnicka MD Thrombin Generation Decrease After LMWH Administration in an Antithrombin-Deficient Pregnant Woman With a Homozygous HBS II Mutation Clinical and Applied Thrombosis/Hemostasis |
| title | Thrombin Generation Decrease After LMWH Administration in an Antithrombin-Deficient Pregnant Woman With a Homozygous HBS II Mutation |
| title_full | Thrombin Generation Decrease After LMWH Administration in an Antithrombin-Deficient Pregnant Woman With a Homozygous HBS II Mutation |
| title_fullStr | Thrombin Generation Decrease After LMWH Administration in an Antithrombin-Deficient Pregnant Woman With a Homozygous HBS II Mutation |
| title_full_unstemmed | Thrombin Generation Decrease After LMWH Administration in an Antithrombin-Deficient Pregnant Woman With a Homozygous HBS II Mutation |
| title_short | Thrombin Generation Decrease After LMWH Administration in an Antithrombin-Deficient Pregnant Woman With a Homozygous HBS II Mutation |
| title_sort | thrombin generation decrease after lmwh administration in an antithrombin deficient pregnant woman with a homozygous hbs ii mutation |
| url | https://doi.org/10.1177/10760296231197174 |
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