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Abstract：
We report the case of a 35-year-old pregnant woman (gravida 3, para 1) with antithrombin deficiency who was successfully treated with apixaban. She had a history of heparin-induced thrombocytopenia and venous thromboembolic events. Pregnancy was confirmed while the patient was having anticoagulant therapy for a persistent thrombus. Choice of anticoagulation during her pregnancy was limited because of her antithrombin deficiency: heparin was not an option because of her history of heparin-induced thrombocytopenia; antithrombin-dependent anticoagulant drugs were not an option because of her antithrombin deficiency, and she preferred outpatient management. Despite the fact that there are no reports of its use in pregnant women, we selected apixaban (10 mg/day), a direct Xa inhibitor, as the best solution. No progression of thrombus was noted during the pregnancy. The newborn baby had no external congenital anomalies, intracranial hemorrhage, or bleeding tendency. Thus, apixaban may be a candidate for anticoagulant therapy in pregnant women with a history of venous thromboembolic events and heparin-induced thrombocytopenia.
摘要：
我们报告了一例35岁的孕妇（gravida3，第1段），患有抗凝血酶缺乏症，并用阿哌沙班成功治疗。她有肝素诱导的血小板减少症和静脉血栓栓塞事件的病史。患者在接受持续血栓的抗凝治疗时确认怀孕。由于抗凝血酶缺乏症，怀孕期间抗凝的选择受到限制：肝素不是一种选择，因为她有肝素诱导的血小板减少症病史；抗凝血酶依赖性抗凝药物不是一种选择，因为她的抗凝血酶缺乏，她更喜欢门诊管理。尽管没有关于其在孕妇中使用的报道，我们选择了阿哌沙班（10毫克/天），一种直接的Xa抑制剂,作为最好的解决方案。妊娠期间未发现血栓进展。新生婴儿没有外部先天性异常，颅内出血,或出血倾向。因此，对于有静脉血栓栓塞事件和肝素诱导的血小板减少症病史的孕妇,阿哌沙班可能是抗凝治疗的候选药物.
