Abstract
A 35-year-old female with swelling of the right lower limb in Week 9 of pregnancy was referred to our hospital. The coagulation marker level was abnormally high, and ultrasonography revealed thrombi in the right femoral and popliteal veins. Furthermore, the antithrombin (AT) activity and antigen level were reduced, suggesting pregnancy with AT deficiency-related thrombosis. As thrombosis exacerbated despite physical therapy, anticoagulant therapy was performed to control thrombosis. The thrombus involved the inferior vena cava, requiring IVC filter insertion. She delivered a baby in Week 38 of pregnancy via transvaginal delivery. There were no maternal or neonatal complications.
It is recommended that prophylactic drug therapy be started in the first trimester in pregnant women with a history of venous thrombosis or thrombophilia. In the present case, it was necessary to perform anticoagulant therapy after admission. On the other hand, admission-related mental stress for pregnant women is marked. Thrombosis control with non-fractional heparin subcutaneously injected at the outpatient clinic was useful. Although pregnant women with thrombosis comprise a high-risk group, it is possible to continue pregnancy through appropriate thrombosis control.
