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. 2017 Jan 10;2017:9261351. doi: 10.1155/2017/9261351

Table 2.

AT concentrate for treatment of VTE in patients with hereditary AT deficiency and pregnancy.

Study Study design Case Thrombotic condition Previous anticoagulation AT Peripartum prophylaxis Type and dosage of AT used Concurrent anticoagulation AT concentrate initiation/duration Goal of AT levels Outcome
Ilonczai et al. 2015 Retrospective Pt1 Bilateral DVT at gw 7 Yes No N/A Therapeutic dose LMWH VTE event to miscarriage  80–120% Miscarriage at gw8
Pt2 PE at gw 7 Yes 50 IU × 2 days 2500 3tw VTE event to delivery Healthy M and N

Rogenhofer et al. (2014) Retrospective Pt1G1 DVT Lt arm at gw 12 Yes N/A 1500 3tw Weight adjusted prophylactic dosage LMWH VTE event to delivery N/A Healthy M and N
Pt1G2 Sinus thrombosis gw 11 1500 Q3D Healthy M and N

Bramham et al. (2013) Retrospective Pt1 Sinus thrombosis gw 11 No 
(new Dx)
50 IU/Kg 3000 IU alternate days Therapeutic UFH infusion VTE event to delivery >80% Healthy M and N
Pt2 Sinus thrombosis gw 9 Yes 50 IU/Kg 3000 IU alternate days N/A Healthy M and N
Pt3 DVT at 28 gw Yes 50 IU/Kg 2000 IU OD × 3 days after IVC filter insertion 3 days after IVC filter insertion M:PE after IVC filter insertion.
N: required NICU

James et al. (2013) Prospective Pt1 DVT, PE at gw 20 No 
(new Dx)
N/A Plasma-derived AT concentrate (Thrombate III) 
Loading dose (in units) = (120% − basal% normal) × wt in kg/1.4 
Maintenance dose = 60% of loading dose
Therapeutic UFH Prior delivery to 6 days postpartum After LD, 80% 
Maintenance dose, 70–120%
Healthy M and N
Pt2 DVT early in pregnancy Yes Preeclampsia early labor Healthy M and N
Pt3 DVT left leg at gw 8 Yes VTE event to delivery Healthy M and N
Pt4 PE at gw 12 Yes VTE event to delivery Healthy M and N
Pt5 DVT at gw 9 Yes VTE to abortion Therapeutic abortion
Pt6 PE at gw 12 Yes VTE to abortion Therapeutic abortion

Tanimura et al. (2012) Case report Pt1 DVT at gw7, HIT No 
(new Dx)
1500 IU for 2 days 3000 IU loading then 1500 IU 2tw UFH then switch to argatroban VTE event to delivery >70% Healthy M and N

Sharpe et al. (2011) Case report Pt1 SVT at gw 34 Yes 3000 IU for 3 days Plasma-derived AT concentrate: 3000 daily for 5 days then alternate 2000 IU and 3000 IU continued for 6 weeks postpartum UFH IV VTE event to delivery 100% Healthy M and N

Hidaka et al. (2008) Case report Pt1 LE DVT at gw 24 No 3000 IU for 1 day 3000 IU 2-3x per week UFH IV + IVC filter VTE event to delivery >70% M: progression of DVT & developed PE

Alguel et al. (2007) Case report Pt1 Pathological flow in umbilical artery at gw 35 Yes 2000 IU for 7 days 6000 IU × 1 dose 
2000 IU × 6 days postpartum
Therapeutic LMWH VTE event to 6 days postpartum >70% Healthy M and N

Shiozaki et al. (1993) Case report Pt1 DVT in early pregnancy, recurrence at gw 37 Yes 2000 IU × 1 day 2000 IU first dose, then 1000 IU once weekly Therapeutic LMWH Gw 37 to 9 days postpartum >80% Healthy M and N

Kario et al. (1992) Case report Pt1 DVT at gw 6 Yes 3000 IU × 1 day Not indicated UFH IV Gw 6, not indicated 
Restarted Gw 34–40 (2° prophylaxis)
>80% Healthy M and N

Menache et al. (1990) PROBE Pt1 DVT at gw 10 Yes Yes Plasma-derived AT-III concentrate 
Total 14,563 IU for 5 d 
Total 17,355 IU for 7 d
UFH IV Gw 10-11 & postpartum (5 days) 80–120% Healthy M and N
Pt2 DVT at gw 14 Yes No GW 14-15 without postpartum prophylaxis M: developed Pelvic and vena cava DVT 4.5 weeks after delivery

Hellgren et al. (1982) Case series Pt1 DVT at gw 13 Yes N/A Plasma-derived AT-III concentrate 
Total 28500 IU for 10 d 
Total 7500 IU for 4 d 
8000 IU for 1 dose
UFH IV Gw 13, abortion  80–120% Therapeutic abortion 
Pt2 DVT at gw 6 Gw 6, miscarriage Miscarriage
Pt3 DVT early in pregnancy A single dose Therapeutic abortion

AT: antithrombin, DVT: deep vein thrombosis, Dx: diagnosis, gw: gestational week, HIT: heparin-induced thrombocytopenia, IU: international units, IVC: inferior vena cava, LE: lower extremity, LMWH: low molecular weight heparin, M: mother, N/A: not available or not specified, N: newborn, OD: daily, PE: pulmonary embolus, PROBE: prospective randomized open blinded end-point, Pt: patient, Q3D: every 3 days, UFH: unfractionated heparin, wt: weight, 2tw: two times per week, and 3tw: three times per week.