Document Detail


Anticoagulation for pregnant patients with mechanical heart valves.
MedLine Citation:
PMID:  17644881     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Management of a pregnant patient with mechanical heart valve is a complex issue for all health care providers involved in the care of such patients. Complications may arise at any stage due to the increased haemodynamic load imposed by pregnancy or because of impaired cardiac performance often seen in these patients. In addition, the use of various cardiovascular drugs in pregnancy (especially anticoagulants) may lead tofoetal loss or teratogenic complications. Additionally, the risk of thrombo-embolic complications in the mother is increased by the hypercoagulable state of pregnancy. In this review, we have attempted to draw inferences to guide management of such patients based on the available literature. It seems that in pregnant women with mechanical heart valves, recent data support warfarin use throughout pregnancy, followed by a switch to heparin and planned induction of labour. However, the complexity of this situation demands a cafeteria approach where the patient herself can choose from the available options that are supported by evidence-based information. Unfortunately there is no consensus on such data. An overview of the available literature forms the basis of this review. In conclusion, a guideline comprising pragmatic considerations is preffered.
Authors:
Aseem R Srivastava; Pranav Modi; Sudhir Sahi; Yogesh Niwariya; Harpreet Singh; Amit Banerjee
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of cardiac anaesthesia     Volume:  10     ISSN:  0971-9784     ISO Abbreviation:  Ann Card Anaesth     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-24     Completed Date:  2007-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815987     Medline TA:  Ann Card Anaesth     Country:  India    
Other Details:
Languages:  eng     Pagination:  95-107     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular and Thoracic Surgery, G. B. Pant Hospital, New Delhi, India.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / chemically induced,  prevention & control
Anticoagulants / administration & dosage,  adverse effects*
Aspirin / administration & dosage,  adverse effects
Drug Administration Schedule
Female
Fetal Diseases / chemically induced,  prevention & control
Heart Valve Prosthesis*
Heparin / administration & dosage,  adverse effects*
Humans
Platelet Aggregation Inhibitors / administration & dosage,  adverse effects
Pregnancy
Pregnancy Complications, Cardiovascular / prevention & control*
Risk Assessment
Thromboembolism / etiology,  prevention & control*
Warfarin / administration & dosage,  adverse effects*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 81-81-2/Warfarin; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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