Failure of therapeutic enoxaparin to prevent massive deep vein thrombosis and cerebral venous sinus thrombosis in a pregnant patient with combined factor v leiden mutation and antithrombin iii deficiency

Women with combined inherited thrombophilia are at high risk of developing thrombotic events, especially when they are pregnant. Low-molecular-weight (LMW) heparins are the preferable agents for anticoagulation during pregnancy. Despite the fact that they have been proven to be effective in the treatment and prevention of venous thromboembolism, thrombotic events can still happen. Here, we report a case of a 40-year-old white pregnant woman with combined factor V Leiden mutation and antithrombin III deficiency who developed massive deep vein thrombosis and cerebral venous sinus thrombosis despite being on therapeutic doses of enoxaparin.