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Intrapartum placement of an inferior vena cava filter for a woman with hereditary antithrombin III deficiency: Its role in the prevention of fatal pulmonary embolism
Author(s) -
Hidaka Nobuhiro,
Hachisuga Masahiro,
Tsukimori Kiyomi,
Onohara Toshihiro,
Maehara Yoshihiko,
Wake Norio
Publication year - 2008
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2007.00708.x
Subject(s) - medicine , pulmonary embolism , antithrombin , antithrombin iii deficiency , thrombus , thrombosis , inferior vena cava , heparin , deep vein , surgery , pregnancy , anesthesia , biology , genetics
We present a case of a pregnant woman with hereditary antithrombin III deficiency and deep vein thrombosis of the left lower extremity managed by perinatal unfractionated heparin injection with antithrombin III replacement as well as by intrapartum placement of a temporary inferior vena cava filter. A massive thrombus of the right common iliac vein occurred during the intrapartum period despite antithrombin III replacement. An inserted filter could prevent fatal pulmonary embolism in this patient. Hereditary antithrombin III deficiency increases risk of thrombosis during pregnancy. However, discussion on intrapartum management, when anticoagulants are contraindicated due to possible hemorrhage, is minimal. Our experience suggests that thrombosis can occur and develop during the intrapartum period in an antithrombin III deficient woman despite antithrombin III replacement. It may be advisable to manage deliveries with temporary inferior vena cava filters to prevent fatal pulmonary embolism.