• Ivana Malikova, Martina Husakova, Jana Bilkova, Radka Brzezkova, and Tomas Kvasnicka.
• Med Princ Pract. 2023 Sep 13; 32 (4-5): 11.

ObjectivesThere is a major problem in providing prophylactic treatment in antithrombin (AT)-deficient pregnant women with a homozygous mutation of the heparin binding site (HBS) and AT level of 17 %. The aim of the study was to determine the effectiveness of heparin by monitoring changes in thrombin generation (TG) in vitro so that pregnant women are not exposed to stress in vivo.MethodsWe used the chromogenic method for determination of factor Xa (FXa) inhibition for enoxaparine, nadroparine, dalteparine, fondaparinux and unfractionated heparin (UFH) and the Thrombin Generation Assay (TGA).ResultsWe found that the degree of inhibition is very different when different heparins are compared. Nadroparin reduces TG the most compared to low molecular weight heparins (LMWH).ConclusionRoutine monitoring of anti FXa activity should be supplemented with TG monitoring, where the effect of LMWH does not manifest itself as this could help in estimating thrombophilic risk during pregnancy.The Author(s). Published by S. Karger AG, Basel.

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