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Pregnancy outcome after mechanical mitral valve replacement: a prospective study
Niloufar Samiei1, Fahimeh Kashfi, Amirjamshid Khamoushi
1Heart Valve Disease Research Center, Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
The Journal of Tehran Heart Center
|January 11, 2013
Summary
Warfarin and Heparin regimens showed similar fetal outcomes for pregnant patients with mechanical heart valves. However, Warfarin demonstrated a safer maternal outcome compared to Heparin.
Area of Science:
- Cardiology
- Obstetrics
- Pharmacology
Background:
- Anticoagulation is essential for pregnant patients with mechanical heart valves.
- Balancing bleeding/embryopathy risks of oral anticoagulants against valve thrombosis is critical.
Purpose of the Study:
- To compare Warfarin and Heparin regimens in pregnant patients with mechanical heart valves.
- To evaluate fetal and maternal outcomes in these high-risk pregnancies.
Main Methods:
- Prospective study of 53 pregnancies (mechanical mitral valves) from 1999-2009.
- Group I (n=43): Warfarin throughout pregnancy.
- Group II (n=10): Heparin (1st trimester) then Warfarin (until 36 weeks).
Main Results:
- Similar fetal outcomes (live births, abortions, stillbirths) between groups.
- Warfarin group had significantly fewer complications (90.7% vs 50%).
- No congenital malformations observed in either group.
Conclusions:
- Both Warfarin and Heparin regimens yield comparable fetal outcomes.
- Warfarin is associated with a safer maternal outcome in this patient population.
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