THROMBOCYTOPENIA, ANTITHROMBIN DEFICIENCY AND EXTENSIVE THROMBOEMBOLISM IN PREGNANCY - TREATMENT WITH LOW-MOLECULAR-WEIGHT HEPARIN

Pregnancy limits the therapeutic options for managing thrombocytopenia which occurs in 5% of patients on heparin. We describe a case of exte nsive thromboembolism associated with antithrombin (AT) deficiency com plicated by thrombocytopenia which resolved when low-molecular-weight heparin was instituted A primigravid woman presented at 11 weeks gesta tion with bilateral femoral occlusive thrombi extending above the rena l veins. Investigations revealed AT deficiency, thrombocytopenia and r enal infarction. After low-molecular-weight heparin was substituted fo r unfractionated heparin, the thrombocytopenia resolved and although t he pregnancy was lost, the patient made a full recovery.