Anticoagulation in a pregnant patient with mechanical heart valves: Case reports and literature review

S. Isezuo, H. Umar, M. Usman, M. Ndakotsu
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Abstract

Patients with prosthetic mechanical heart valves require a life-long anticoagulation. This is more so during pregnancy which increases the risk of thrombosis. We present two pregnant patients with prosthetic mechanical valves managed up to delivery. All the patients were on warfarin before conception which was changed to unfractionated heparin after confirmation of pregnancy. At 14 weeks gestation, they were changed back to warfarin until 36 weeks gestation. Unfractionated heparin was reintroduced until delivery. All the patients had minimal postpartum hemorrhage. Mrs. XX, one of them, had four successful deliveries since the placement of mechanical valve. Pregnancy for a woman mechanical valve poses a greater risk to both the mother and the fetus. This group of women should have preconception care in a specialized program.
机械心脏瓣膜妊娠患者的抗凝治疗:病例报告和文献复习
人工心脏机械瓣膜患者需要终身抗凝治疗。在怀孕期间更是如此,这会增加血栓形成的风险。我们提出了两个怀孕的病人与假体机械瓣膜管理到分娩。所有患者受孕前均使用华法林,确认妊娠后改用肝素。在妊娠14周时,她们又重新使用华法林,直到妊娠36周。再次使用未分离肝素直至分娩。所有患者均有轻微的产后出血。其中的XX女士,在放置机械瓣膜后,已经成功分娩了4次。女性怀孕时使用机械瓣膜对母亲和胎儿都有更大的风险。这组妇女应该在一个专门的项目中接受孕前护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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