[Pregnancy complicated with antithrombin Ⅲ deficiency: a case report and literature review]

Objective: To report the diagnosis and treatment of a pregnant woman with antithrombin (AT) Ⅲ deficiency in pregnancy, and combine the diagnosis and treatment ideas with the literature. Methods: The clinical diagnosis and treatment process of one pregnant woman with AT-Ⅲ deficiency admitted to the Second Affiliated Hospital of Zhengzhou University from October 2023 to June 2024 were retrospectively analyzed. Combined with relevant literature, the effect of pregnancy with AT-Ⅲ deficiency on pregnancy outcome was summarized, and reference was provided for the formulation of anticoagulant regimen. Results: The patient had 3 adverse pregnancy histories and a deep venous thrombosis of the lower limbs. The AT activity fluctuated between 34% and 50% during this pregnancy. The patient received 3 transfusions of fresh frozen plasma during pregnancy and was administered low molecular weight heparin from pre-pregnancy until 24 hours before delivery. Warfarin, hydroxychloroquine, cyclosporine and methylprednisolone were added in the second trimester. The pregnancy was terminated at 35 weeks of gestation. The infant was born with a weight of 2,330 g and was transferred to the pediatric department for treatment. After 14 days, the infant was discharged. Follow-up to date has not revealed any abnormalities. Conclusion: Precise treatment of pregnancy with AT-Ⅲ deficiency can effectively improve pregnancy outcomes.