Key result
A planned pregnancy using a regimen of heparin during the first trimester and peripartum period, and warfarin during the second and early third trimesters, resulted in a successful delivery without complications in a woman with a St Jude Medical mitral valve prosthesis.
Why the study?
Does a sequential heparin and warfarin anticoagulation strategy prevent thromboembolic and hemorrhagic complications during pregnancy in a woman with a mechanical mitral valve?
Case Report (n=1)
No
Does a sequential heparin and warfarin anticoagulation strategy prevent thromboembolic and hemorrhagic complications during pregnancy in a woman with a mechanical mitral valve?
Successful pregnancy and delivery in a patient with a St Jude Medical mitral valve prosthesis is possible with careful maintenance of anticoagulation using a sequential combination of heparin and warfarin.
May inform anticoagulation strategies in pregnant women with mechanical mitral valves; leaves open need for larger prospective studies.
A primiparous woman with a St Jude Medical (SJM) mitral valve prosthesis and receiving anticoagulant drug delivered a healthy male infant by spontaneous normal vaginal delivery. Oral warfarin was replaced by subcutaneous heparin at the 6th week of gestation and the dosage of heparin was adjusted to maintain a partial thromboplastin time between 2.0 and 2.5 times the control value. Treatment with heparin was administered during the first trimester and the last 5 weeks of gestation. Warfarin was used between the 13th and 32nd week. Successful pregnancy and delivery in patients with a SJM mitral valve prostheses is possible with careful maintenance of anticoagulation.
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Fukuda et al. (2002) conducted a case report in Pregnancy with St Jude Medical prosthetic mitral valve (n=1). Heparin and warfarin anticoagulation regimen was evaluated on Successful pregnancy and delivery. A planned pregnancy using a regimen of heparin during the first trimester and peripartum period, and warfarin during the second and early third trimesters, resulted in a successful delivery without complications in a woman with a St Jude Medical mitral valve prosthesis.
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