Hereditary antithrombin III deficiency: pregnancy management and delivery

Kurlovich I.V., Pankratova O.A., Peresada O.A., Zubovskaya E.T.

1) Republican Scientific and Practical Center “Mother and Child”, Minsk, Republic of Belarus; 2) Belarusian State Medical University, Minsk, Republic of Belarus

This study was aimed to evaluation of the effectiveness of intensive replacement therapy with antithrombin III concentrate in combination with low-molecular-weight heparins in a pregnant woman with hereditary antithrombin III deficiency and a high risk of thrombotic complications, as well as to identification of key organizational aspects of management.
This article presents a case of a 22-year-old primigravida with confirmed hereditary antithrombin III deficiency, followed from the seventh week of gestation. Against the background of therapy with low molecular weight heparins and replacement administration of antithrombin III concentrate (26 administrations, total dose 48,000 IU), antithrombin III activity varied: in the first trimester, the median was 40.0% [38.0; 45.2], in the second – 38.0% [35.2; 47.9], in the third trimester, despite 11 administrations, a critical decrease to 25% was noted (median 47.0% [25.0; 47.0]). In the postpartum period, activity recovered to 65.9% [61.6; 68.7]. Delivery was performed by cesarean section at 37–38 weeks with favorable outcomes for the mother and newborn. A multidisciplinary approach with intensive monitoring, the use of low-molecular-weight heparins, and regular replacement therapy with antithrombin III concentrate provides successful pregnancy outcomes in patients with hereditary antithrombin III deficiency.

For citations: Kurlovich I.V., Pankratova O.A., Peresada O.A., Zubovskaya E.T. Hereditary antithrombin III deficiency: pregnancy management and delivery. Pharmateca. 2026;33(4):200-209. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.4.200-209

Authors’ contribution: The authors declare that their authorship complies with the international ICMJE criteria. O.A. Pankratova and I.V. Kurlovich collected and processed the material, and wrote the text. O.A. Peresada and E.T. Zubovskaya edited the article.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The authors declare no external funding for the study and publication of the article.
Patient Consent for Publication: Written voluntary informed consent was obtained from the patient for publication of the examination and treatment results

Keywords

About the Authors

I.V. Kurlovich, Cand. Sci. (Med.), Associate Professor, Deputy Director for Research, Republican Scientific and Practical Center “Mother and Child”, Minsk, Republic of Belarus; ivan.kurlovich@gmail.com, ORCID: https://orcid.org/0009-0009-7384-8460 (corresponding author)
O.A. Pankratova, Cand. Sci. (Med.), Associate Professor, Obstetrician-Gynecologist, Head of the Department of Pregnancy Pathology No. 1, Republican Scientific and Practical Center “Mother and Child”, Minsk, Republic of Belarus; o.pankratova777@gmail.com, ORCID: https://orcid.org/0009-0002-8206-9513
O.A. Peresada, Dr. Sci. (Med.), Professor, Department of Obstetrics and Gynecology, Institute for Advanced Training and Retraining of Healthcare Personnel, Belarusian State Medical University, Minsk, Belarus; dr-olga@yandex.by, ORCID: https://orcid.org/0009-0009-5219-3784
E.T. Zubovskaya, Cand. Sci. (Med.), Associate Professor, Senior Researcher, Laboratory of Obstetric and Gynecological Pathology, Republican Scientific and Practical Center “Mother and Child”, Minsk, Belarus; laigp@medcenter.by, ORCID: https://orcid.org/0009-0002-4781-7854

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