Pregnancy Outcomes in Patients with Heart Valve Replacement: Sohag Perspective

Background: Management of a pregnant woman with a prosthetic heart valve requires significant contemplations, particularly concerning looking after anticoagulation. Objective: We directed this observational study to notice maternal and fetal results in pregnant women with heart valve replacement in Sohag University Hospital. Patients and methods: An observational study was done in Sohag University Hospital, 20 cases recruited in Department of Obstetrics and Gynecology during the period from April 2019 to October 2019. All cases were exposed to finish history taking, total physical assessment (general and obstetrical), obstetric US and investigations as echocardiography, PT, PC and INR. Results: The mean age of the study group was around 28 years, with a range from 18 to 38 years. The vast majority of the cases had mitral valve replaced. CS was done for 40% of the cases, followed by vaginal delivery in 35% of them, evacuation in 20% and hysterotomy in one case (5%). Hemorrhagic complications were seen in 25% of the cases, followed by thrombosis and rapid AF (10% each), then heart failure and supraventricular arrhythmias (5% each). Miscarriage before the 24th week occurred in 30% of the cases and IUFD in one case (5%). Before 14 weeks of gestation, most of the cases used heparin either UFH or LMWH, with only 35% used vitamin K antagonists. Hemorrhage was more common with MVR. Conclusion: Patients with mechanical valves have more rate of fetal misfortunes and maternal complexities. Mitral valve replacement is related with more maternal hemorrhagic complications than aortic valve alone or double valve substitution.