Does VKA compared to LMWH improve maternal and fetal outcomes in pregnant women with mechanical heart valves?
In pregnant women with mechanical heart valves, VKA minimizes maternal risk while LMWH minimizes fetal risk, though low-dose warfarin (≤5 mg daily) has similar fetal risk to LMWH.
VKA treatment was associated with the lowest risk of adverse maternal outcomes, whereas the use of LMWH throughout pregnancy was associated with the lowest risk of adverse fetal outcomes. Fetal risk was similar between women taking ≤5 mg warfarin daily and women treated with LMWH.
Steinberg et al. (Wed,) studied this question.