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Pregnant Woman in Outcomes with Prosthetic Heart Valves
Giunai Sefiyeva1, Ulyana Shadrina1, Tatiana Vavilova1
1Almazov National Medical Research Centre, St. Petersburg 197341, Russia.
Journal of Cardiovascular Development and Disease
|November 26, 2024
Summary
Women with prosthetic heart valves (PHV) face risks during pregnancy. Effective anti-factor Xa control reduced thrombotic events, but postpartum bleeding remains a concern, necessitating adjusted anticoagulant therapy.
Area of Science:
- Cardiology
- Obstetrics
- Thrombosis Research
Background:
- Pregnancy in women with prosthetic heart valves (PHV) presents unique challenges.
- Managing anticoagulation is critical to balance thrombotic and hemorrhagic risks.
Purpose of the Study:
- To assess thrombotic and hemorrhagic complications in pregnancies with PHV.
- To identify associated risk factors during pregnancy, delivery, and postpartum.
Main Methods:
- Retrospective cohort study (January 2011-December 2022) of 88 pregnancies with 77 PHV.
- Comparison between mechanical valve prostheses (MVP) and biological valve prosthesis (BVP) groups.
- Analysis of pregnancy outcomes, thrombotic, and hemorrhagic complication frequencies.
Main Results:
- 79 live births out of 88 pregnancies.
- MVP group: 17.2% thrombotic complications during pregnancy, 17.9% postpartum hemorrhagic complications.
- BVP group: 4.2% transient ischemic attack; no postpartum thrombotic or hemorrhagic events.
Conclusions:
- Effective anti-factor Xa control mitigated thrombotic events.
- High postpartum hemorrhage incidence indicates a need to revise anticoagulant regimens and target levels.
- Despite risks, no maternal mortality was observed in this cohort.
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