Current possibilities of personalized thromboprophylaxis when implementing an assisted reproductive technology protocol and during pregnancy in women at high risk for venous thromboembolism


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Abstract

Background. Personalized anticoagulant prevention of venous thromboembolism (VTE) in women with a complicated obstetric history (COH) and thrombophilia can prolong pregnancy and improve its outcome. Therapy can be individually monitored by global tests evaluating the hemostatic system. Case report. The paper gives an example of managing a patient with COH and thrombophilia at high risk for VTE (congenital antithrombin III deficiency) in the assisted reproductive technology (ART) protocol and during pregnancy. The dose of anticoagulants was controlled and adjusted using the routine and global hemostasis tests until the pregnancy was successfully completed: delivery by caesarean section at 38 weeks’ gestation; a full-term baby weighing 3980 g; an Apgar score of 9. Conclusion. Implementation of the ART protocol in women with thrombophilia at high risk for VTE should be accompanied by careful hemostasiological monitoring and individual choice of anticoagulant prevention. When severe underlying pathological hypercoagulation or evident uncontrollable hemostasis is identified by the time of embryo transfer, the latter should be postponed until hemostasis is stabilized.

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About the authors

Svetlana I. Safiullina

Kazan State Medical University; Medical Center «Aybolit» LLC

Email: Svetlana.ild.safiullina@gmail.com
Ph.D., Teaching Fellow Chair of General Medical Practice; Hematologist

Tatiana A. Vuimo

Dmitry Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia

Email: tagaty@yandex.ru
Cand. Biol. Med., Leading Research in Laboratory of Translational medicine, Higher School of Molecular and Experimental Medicine

Natalia A. Ilizarova

Kazan State Medical University

Email: nilizarova@mail.ru
Ph.D., Dr. Scient. Med, Assistant Professor, Chair of Obstetrics and Gynecology № 2

Venera L. Sabirova

OOO “Ava Kazan” Multidisciplinary Clinic

Email: venera.sabirova.83@mail.ru
obstetrician-gynecologist - reproductologist, head of the department of IVF

Lga N. Sigitova

Kazan State Medical University

Email: osigit@rambler.ru
professor, doctor of medical Sciences, head of the Department of General practice

Alexey V. Pyregov

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: pyregov@mail.ru
Ph.D., Head of the Department of Anesthesiology and Reanimation

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