Why the study?
Prosthetic heart valves in pregnancy pose high maternal and fetal risks, with no entirely safe anticoagulation strategy to balance valve thrombosis against bleeding and embryopathy.
Management of pregnant women with prosthetic heart valves requires an individualized, multidisciplinary approach to balance the competing risks of valve thrombosis against maternal and fetal bleeding or embryopathy.
Individualized anticoagulation decisions remain essential for prosthetic valves in pregnancy; Level 5 evidence leaves open safer regimens for prospective trials.
The presence of prosthetic heart valve in pregnancy causes significant risk to mother and fetus and poses a great management challenge. There is a high risk of valve thrombosis necessitating uninterrupted anticoagulation which may lead to increased risk of maternal and fetal bleeding as well as embryopathy. There is no anticoagulation strategy that is entirely safe and difficult decisions need to be taken. No single approach fits all patients and patient care needs to be individualized. Preconception counseling and evaluation by the multidisciplinary team taking in account all the associated risk factors helps in providing a balanced comprehensive approach for the best possible outcome.
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Yadav et al. (2024) studied this question.
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