Continued oral anticoagulants during pregnancy in women with mechanical heart valve prostheses resulted in an 8.5% fetal mortality rate and full-term delivery in 40 of 47 pregnancies.
Observational (n=37)
Pregnancy after valve replacement has been considered hazardous because of maternal and fetal complications secondary to anticoagulant medication, in addition to basic myocardial problems. Of 229 females aged 15-45 years with prosthetic valve replacement, 37 (including 34 with Björk-Shiley valve and anticoagulants) subsequently had a total of 47 pregnancies. Fullterm delivery of a normal infant was achieved in 40 cases. There were three premature births, two spontaneous abortions, one stillbirth and one ectopic pregnancy. The fetal mortality was 8.5%. Valve thrombosis developed in two cases, but surgical treatment was successful. Oral anticoagulants (acenocoumarin and dipyridamole) were continued throughout pregnancy. Heparin was substituted before labour began, but discontinued after delivery, when effective oral anticoagulation was resumed. Our experience showed that pregnancy in women with mechanical heart valve prosthesis and continued oral intake of anticoagulants is safe and successful in most cases.
Pavankumar et al. (1988) conducted an observational in Prosthetic cardiac valve (n=37). Continued oral anticoagulants during pregnancy was evaluated on Fetal mortality. Continued oral anticoagulants during pregnancy in women with mechanical heart valve prostheses resulted in an 8.5% fetal mortality rate and full-term delivery in 40 of 47 pregnancies.