Manejo obstétrico de la deficiencia hereditaria de antitrombina durante el embarazo y puerperio. Dos casos clínicos

Abstract

Introduction: hereditary antithrombin III deficiency is a rare disease that affects 0.02-0.2% of the population. It may be associated with a higher rate of complications and adverse outcomes in both mother and fetus. The present study describes the management of a woman with antithrombin III deficiency and two consecutive pregnancies. Description: in both pregnancies, the woman under went prophylaxis with low molecular weigh heparin, to prevent thromboembolic disease and improve the utero-placental flow during pregnancy and the postpartum period. The only obstetric complication was fetal growth retardation requiring strict obstetric control. In these two cases the eco-Doppler studies of feto-placental flow were normal, leading to the expectation of managing a term birth. Discussion: low molecular weigh heparin prophylaxis in pregnant women with thrombophilia and preventive interventions for risk factors for thromboembolic disease, together with appropriate obstetric care managed to avoid the emergence of complications of this disease in pregnancy and puerperium. Fetal growth control and a Doppler study also help to ensure the well-being of the fetus and avoid a preterm birth.