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ANTICOAGULANT THERAPY WITH CARDIAC VALVE PROSTHESIS DURING PREGNANCY

Department of Obstetrics and Gynecology at The Methodist Hospital, Brooklyn, New York.

A case of mitral valve prosthesis in pregnancy is presneted. Patients undergoing this type of surgery are often young females desirous of pregnancy with whom a definitve plan should be discussed. The literature is reviewed and maternal and fetal risks evaluated. One indirect maternal death is reported out of 46 pregnancies in 41 patients. Three other deaths occurred 9 months after delivery—a mortality rate which is no higher than if pregnancy had not occurred. Morbidity in the form of nonfatal embolic phenomena also was noted in 5 patients, 4 of these were arterial in origin. The fetal wastage was 14 out of 46 conceptuses including 2 abortions, 5 stillbirths, 4 neonatal deaths and 3 major congential anomalies. Various anticogulant regimens reported in the literature are reviewed and a possible teratogenic effect of the warfarin group is postulated. The most suitble anticoagulant regimen with relationship to gestational age is discussed.

This article has been cited by other articles:

				D. Oles, R. Berryessa, K. Campbell, and M. A. Bhatti Emergency redo mitral valve replacement in a 27-year-old pregnant female with a clotted prosthetic mitral valve, preoperative fetal demise and postoperative ventricular assist device: a case report Perfusion, March 1, 2001; 16(2): 159 - 164. [Abstract] [PDF]