January 24, 2000Archives of Internal Medicine
Anticoagulation of Pregnant Women With Mechanical Heart Valves
Why the study?
Does substituting oral anticoagulants with heparin between 6 and 12 weeks of gestation improve fetal outcomes without unacceptably increasing maternal thromboembolic risk in pregnant women with mechanical heart valves?
Population
Pregnant women with mechanical heart valves
Comparison
Heparin substitution between 6 and 12 weeks of… vs Continuous oral anticoagulants (OA)
Design
Review
Authors
Discussion
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Implication
Trade-off warrants individualized decisions in mechanical valve pregnancies; leaves open optimal regimen without prospective trials.
Structured PICO
Does substituting oral anticoagulants with heparin between 6 and 12 weeks of gestation improve fetal outcomes without unacceptably increasing maternal thromboembolic risk in pregnant women with mechanical heart valves?
P
Population
Pregnant women with mechanical heart valves
I
Intervention
Heparin substitution between 6 and 12 weeks of gestation
C
Comparator
Continuous oral anticoagulants (OA)
O
Outcome
Thromboembolic complications and fetal embryopathyhard clinical
Anticoagulation in pregnant women with mechanical valves requires a careful balance between maternal thromboembolic risk and fetal embryopathy, highlighting a critical need for large prospective trials to define the optimal regimen.
Limitations
- Lack of large prospective trials to determine the optimal regimen
Cite This Study
Chan et al. (2000) studied this question.