Heart valve replacement; anticoagulation and pregnancy

Three patients who had heart valve replacement surgery and were on anticoagulation therapy with warfarin presented with pregnancy, one patient in the first trimester and the other two patients in the second trimester All three patients were in good and stable haemodynamic condition and went through pregnancy without any Complications. Delivery in all three patients were by caesarian section. The management of these patient during pregnancy and delivery form the basis of this report. A scheme for anticoagulation therapy during pregnancy, delivery and the post-delivery period of such patients has also been presented.