[Anticoagulation's problematic during pregnancy in carriers of mechanical heart prosthesis]

The heart prosthesis pregnant women are becoming more frequent due to the persistence of rheumatic fever in the country sends developments.

To propose management strategies from preconception to pregnancy and postpartum.

Prospective study from 2009-2014 about parturientes followed in cardiology and maternity on center Hospitalo University Oran.

Thirty patients were followed, ejection fraction was equal to 60% in 29 cases. A single case of stenosis of the aortic prosthesis. Sixteen received low molecular weight heparins (LMWH) enoxaparine kind between 6 and 12 weeks, 13 received l'acenocoumarol (AVK) in the first quarter. One patient had been insufficient dose enoxaparine to 1/day and complicate ischemic stroke, abortion of a fetus of 16 weeks malformed in a mother who received acenoucoumarol (AVK) in the first quarter. Maternal mortality was null.

LMWHs were 100% effective in sufficient doses, the VKA and LMWH relay period was critical and should be done in a hospital setting.

Wearing a prosthetic valve is compatible with supervised pregnancy LMWHs were 100% effective, provided they were used in sufficient doses between 6-12 weeks of amenorrhea.