MANAGEMENT OF ILIOFEMORAL THROMBOSIS IN A PREGNANT PATIENT WITH HEPARIN RESISTANCE

A 25-year-old primiparous woman presented at 30 weeks of gestation wit h suspected deep vein thrombosis of the left leg, Results of initial n oninvasive tests were not in agreement and subsequent venographic find ings revealed left iliac vein thrombosis, Treatment was initiated with continuous intravenous unfractionated heparin sodium for 3 days and t hen switched to twice-daily subcutaneous unfractionated heparin. Unfra ctionated heparin, 60 000 U per 24 hours, was required to maintain the activated partial thromboplastin time within the therapeutic range, w hich posed problems because of large volumes of injection. Therapy wit h subcutaneous low-molecular-weight heparin was successfully substitut ed and the patient had an uncomplicated full-term delivery.