2002 Volume 54 Issue 4 Pages 297-301
Pregnancy associated deep venous thrombosis (DVT) is a major risk factor for pulmonary embolism and is a major cause for maternal death. In this case report, we experienced a patient with DVT appeared at 4th-day puerperium. She was a 28-year-old primipara and complained of sudden pain and swelling in her left leg. Because the symptoms became severe and the redness of skin of left leg and Homans sign were also appeared at 5-th day puerperium, a CT scan was performed and its results indicated thrombosis in the left femoral vein. Therefore, a diagnosed of DVT was made. She was initially treated with intravenous administration of urokinase following by heparin. Since the results of coagulation activity tests indicated the low antigenic titier (55%) of antithrombin, the administration of antithrombin was also performed. After the initial treatment was completed and her symptoms were improved, oral anticoagulant therapy with warfarin sodium was started at 17-th day puerperium. The laboratory data of the same day indicated that antithrombin activity and antigenic titer were still lower (66%) than normal range. Her mother also showed low antithrombin activity and a relative of hers had had a pulumonary embolism. On the basis of these data, a diagnosis of congenital antithrombin deficiency was finally made. She fortunately did not suffer a pulmonary embolism and improved after treatment.[Adv.Obstet.Gynecol.,54 (4) : 297-301, 2002 (H. 14. 7)]
