Nelson D M, Stempel L E, Brandt J T
Obstet Gynecol. 1985 Jun;65(6):848-53.
The pregnancy and the serum antithrombin III levels during the antenatal and postpartum period of two patients with hereditary antithrombin III deficiency is described. Both antithrombin III antigen and activity levels dropped to their lowest levels immediately after delivery. A review of the literature emphasizes the high risk for thromboembolism in patients with hereditary antithrombin III deficiency. Important considerations for the obstetrician concerning hereditary antithrombin III deficiency are discussed, including: 1) the need to therapeutically anticoagulate these patients postpartum, 2) the need to consider prophylactic anticoagulation throughout pregnancy especially in patients with a history of thrombosis, 3) the practical aspects of assaying antithrombin III in plasma rather than serum, 4) the normally low antithrombin III levels in normal newborns, and 5) the need to provide prepregnancy counseling, including information about the autosomal dominant inheritance of hereditary antithrombin III deficiency.
本文描述了两名遗传性抗凝血酶III缺乏症患者在产前和产后期间的妊娠情况及血清抗凝血酶III水平。两名患者的抗凝血酶III抗原和活性水平在分娩后立即降至最低水平。文献综述强调了遗传性抗凝血酶III缺乏症患者发生血栓栓塞的高风险。讨论了产科医生在处理遗传性抗凝血酶III缺乏症时的重要注意事项，包括：1) 产后对这些患者进行治疗性抗凝的必要性；2) 整个孕期考虑预防性抗凝的必要性，尤其是有血栓形成病史的患者；3) 检测血浆而非血清中抗凝血酶III的实际操作问题；4) 正常新生儿抗凝血酶III水平通常较低的情况；5) 提供孕前咨询的必要性，包括关于遗传性抗凝血酶III缺乏症常染色体显性遗传的信息。
