{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:08:18Z","timestamp":1753862898758,"version":"3.41.2"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The anticoagulants of choice for the prevention and treatment of venous thromboembolic disease during pregnancy are unfractionated heparin and low\u2010molecular\u2010weight heparin. Heparin\u2010induced thrombocytopenia (HIT) is introduced as a rare but critical side effect of heparin products raising the thromboembolic event paradoxically. Here, we present a case of HIT in pregnancy with challenging management due to coincidence of lupus anticoagulant (LA) and limited anticoagulant options in the pharmaceutical market of our country of residence. We describe a 6\u2010week pregnant patient with deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE), which developed HIT during antenatal care. Therapeutic anticoagulation was initiated with argatroban, then switched to apixaban due to limited access to argatroban. Another therapeutic challenge was the concurrent incidence of LA. The interdisciplinary care team decided on adding up warfarin and scheduled termination at 12\u2009weeks regarding the hazardous condition of the patient. We also reviewed related case literature to convey a new insight into managing pregnancy\u2010related HIT. HIT is a pro\u2010coagulatory and lethal complication associated with heparin therapy that can be diagnosed by clinical suspicion, the 4T score system, and confirmatory laboratory analyses. Alternative anticoagulation is the cornerstone of the treatment and an interdisciplinary plan will be worthwhile to make the best clinical decision regarding the critical situation and least the thromboembolic events mortality during pregnancy.<\/jats:p>","DOI":"10.1002\/ccr3.7839","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T03:47:11Z","timestamp":1692676031000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Heparin induced thrombocytopenia in pregnancy: A\u00a0therapeutic challenge case report and literature review"],"prefix":"10.1002","volume":"11","author":[{"given":"Seyyed Mojtaba","family":"Nekooghadam","sequence":"first","affiliation":[{"name":"Department of Internal Medicine School of Medicine Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sepehr","family":"Ebrahimi\u2010Dehkordi","sequence":"additional","affiliation":[{"name":"Student Research Committee Shahrekord University of Medical Sciences  Shahrekord Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elham","family":"Paraandavaji","sequence":"additional","affiliation":[{"name":"Skull Base Research Center Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"Pishgahi","sequence":"additional","affiliation":[{"name":"Department of Cardiology School of Medicine Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3903-0464","authenticated-orcid":false,"given":"Erfan","family":"Ghadirzadeh","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elham","family":"Charkazi","sequence":"additional","affiliation":[{"name":"Semnan University of Medical Sciences  Semnan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5077-7307","authenticated-orcid":false,"given":"Parastoo","family":"Ghorbani","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2015.11.009"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2021.09.001"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crwh.2020.e00200"},{"key":"e_1_2_13_5_1","article-title":"Heparin\u2010induced thrombocytopenia occurring in the first trimester of pregnancy: successful treatment with lepirudin. 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