Neuraxial anesthesia for labor and cesarean delivery in a parturient with hereditary antithrombin deficiency on recombinant human antithrombin infusion therapy

Pamnani, Anup; Rosenstein, Megan; Darwich, Alaeldin A.; Wolfson, Alexander

doi:10.1016/j.jclinane.2009.05.008

Cited by 10 publications

(3 citation statements)

References 17 publications

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“…In one report, no AT concentrate was given at the time of delivery,40 while, in another report, FFP was given but no AT concentrate 37. In five reports, peripartum AT concentrate was given just at the time of delivery32,34,36,42,45 and in another five, AT concentrate was given for several days surrounding the time of delivery 16,27,28,35,43. One study reported the administration of AT concentrate for 6 weeks postpartum 44.…”

Section: Discussionmentioning

confidence: 99%

“…In one report, loading doses of 50 units/kg were administered, with maintenance doses of 25 units/kg every 48 hours. For recombinant AT concentrate, loading doses ranged from 21 to 81 units/kg and maintenance infusions ranged from 160 to 436 IU/kg/day and were administered for 3–10 days29 or, in one case report, 3091 units followed by a maintenance infusion of 712 units per hour 43. As for indications, only 29/53 cases had a personal history of VTE, with the others diagnosed with AT deficiency based on a family history.…”

Section: Discussionmentioning

confidence: 99%

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Prevention and treatment of venous thromboembolism in pregnancy in patients with hereditary antithrombin deficiency

James¹,

Konkle²,

Bauer

2013

IJWH

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ObjectiveThe aims of the study reported here were to provide data from six pregnant subjects who were enrolled in a clinical trial of antithrombin (AT) concentrate, discuss other published case series and case reports, and provide general guidance for the use of AT concentrate for inherited AT deficiency in pregnancy.MethodsIn the late 1980s, 31 AT-deficient subjects were enrolled in a prospective treatment trial of the plasma-derived AT concentrate Thrombate III®. Herein, newly available treatment data about the six pregnant subjects in the trial is tabulated and summarized.ResultsAll six experienced venous thromboembolism (VTE) during pregnancy, were dosed according to a weight-based protocol, and were treated concomitantly with anticoagulation. Loading doses of AT concentrate of 54–62 units/kg were followed by maintenance doses of 50%–100% of the loading dose for 3–10 days. At the time of labor, loading doses of 46–50 units/kg were followed by maintenance doses of 50%–75% of the loading dose for 5–7 days. None of the six experienced recurrent thrombosis while receiving treatment with AT concentrate.ConclusionCurrently we suggest that women with AT deficiency who are pregnant or postpartum and have a personal history of VTE or current VTE receive AT concentrates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevention and treatment of venous thromboembolism in pregnancy in patients with hereditary antithrombin deficiency

James¹,

Konkle²,

Bauer

2013

IJWH

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“…cesarean section, elective surgery and delivery) (Tiede et al, 2008). There are a limited number of case reports stating successful administration of epidural anesthesia and analgesia under an antithrombin treatment in hereditary antithrombin deficiency (Pamnani et al, 2010).…”

Section: Antithrombin III Deficiencymentioning

confidence: 99%

Epidural Analgesia - Current Views and Approaches

Fyneface-Ogan¹

2012

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