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May 31, 2017Journal of the American College of Cardiology166 citationsOpen Access

Maternal and Fetal Outcomes of Anticoagulation in Pregnant Women With Mechanical Heart Valves

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ZSZachary L. SteinbergCDClara Domínguez‐IslasCOCatherine M Otto

Structured PICO

Does VKA compared to LMWH improve maternal and fetal outcomes in pregnant women with mechanical heart valves?

P
Population
Pregnant women with mechanical heart valves
I
Intervention
Vitamin K antagonist (VKA) treatment (including warfarin)
C
Comparator
Low-molecular-weight heparin (LMWH)
O
Outcome
Adverse maternal outcomes and adverse fetal outcomeshard clinical

In pregnant women with mechanical heart valves, VKA minimizes maternal risk while LMWH minimizes fetal risk, though low-dose warfarin (≤5 mg daily) has similar fetal risk to LMWH.

Abstract

VKA treatment was associated with the lowest risk of adverse maternal outcomes, whereas the use of LMWH throughout pregnancy was associated with the lowest risk of adverse fetal outcomes. Fetal risk was similar between women taking ≤5 mg warfarin daily and women treated with LMWH.

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Cite This Study

Steinberg et al. (2017) studied this question.

synapsesocial.com/papers/69d56e0975589c71d767d306https://doi.org/10.1016/j.jacc.2017.03.605
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Anticoagulation of Pregnant Women With Mechanical Heart Valves Using Low-Molecular-Weight Heparin2003 · 8 citations
  2. 2Late Thrombotic Malfunction of the Björk–Shiley Tilting Disc Valve in the Tricuspid Position.Principles for Recognition and Management1980 · 43 citations
  3. 3Limited dose warfarin throughout pregnancy in patients with mechanical heart valve prosthesis: a meta-analysis2014 · 97 citations
  4. 4ESC Guidelines on the management of cardiovascular diseases during pregnancy2011 · 1,933 citations
  5. 5Should a Mechanical or Biological Prosthesis Be Used for a Tricuspid Valve Replacement? A Meta-Analysis2016 · 53 citations