Why the study?
Does warfarin throughout pregnancy compared to heparin substitution improve maternal and fetal outcomes in pregnant women with prosthetic heart valves?
Population
196 pregnancies in 110 women with prosthetic heart valves (from 1974 to 2000)
Comparison
Warfarin throughout pregnancy vs Warfarin replaced by subcutaneous heparin during…
Design
Cohort
Follow-up
throughout pregnancy
Authors
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Warfarin was associated with more fetal loss but less thrombosis than heparin substitution in prosthetic valve pregnancies; leaves open optimal regimen pending randomized data.
Does warfarin throughout pregnancy compared to heparin substitution improve maternal and fetal outcomes in pregnant women with prosthetic heart valves?
In pregnant women with prosthetic heart valves, warfarin is more effective for the mother but increases fetal loss (especially at doses >5 mg), whereas heparin substitution protects the fetus but increases maternal valve thrombosis risk.
Khamooshi et al. (2007) studied this question.
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