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Published on: February 26, 2013
Anticoagulation in pregnant women with a bileaflet mechanical cardiac valve replacement
Kyung-Hwan Kim1, Dong Seop Jeong, Hyuk Ahn
1Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. kkh726@snu.ac.kr
Background:
We investigated the risk and outcome of anticoagulation in pregnant women who had a mechanical valve.
Materials And Methods:
This retrospective study was undertaken for 41 pregnancies (27 women, 33.1 +/- 4.7 years old) from January 1990 to December 2005. Patients were divided into 3 groups: group I (n = 5) took warfarin throughout the pregnancy, group II (n = 18) took heparin throughout the pregnancy, and group III (n = 18) took heparin in the 1st trimester and warfarin from a gestational age of 12 to 20 weeks.
Results:
Twenty-three pregnancies (56.1%) resulted in live births, 11 (26.8%) in stillbirths, and 8 (19.5%) in spontaneous abortions (SA). In group I, there were 2 live births (40.0%), 2 stillbirths (40.0%), and 1 SA (20.0%); in group II, there were 10 live births (55.6%), 1 stillbirth (5.6%), and 7 SA (38.9%); and in group III, there were 10 live births (55.6%), 8 stillbirths (44.4%), and no SA. No significant difference was observed between the 3 groups in terms of successful delivery rates (P = .826).
Conclusion:
The probability of successful delivery was low. No single reliable anticoagulation protocol in pregnant patients with mechanical valves emerged from the collated data.
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