Document Detail


Low-molecular-weight heparin in pregnant women with prosthetic heart valves.
MedLine Citation:
PMID:  17044374     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Low-molecular-weight heparin (LMWH) is considered a recommended anticoagulation option in pregnant women with prosthetic heart valves. However, few data are available regarding the efficacy and safety of LMWH in this setting. METHODS: In 1999, the authors' institution developed a standardized anticoagulation protocol for pregnant women with prosthetic heart valves, which included LMWH administered between six and 12 weeks' gestation, and after 36 weeks, with prespecified target levels, and additional low-dose aspirin. Herein is presented the initial experience using this anticoagulation regimen. RESULTS: Among five women with prosthetic heart valves treated with LMWH during part of their pregnancy, four had uneventful pregnancies while one suffered a coronary artery embolus. A review is provided of the current state of knowledge regarding anticoagulation in pregnancy, with emphasis placed on the importance of strict monitoring of anticoagulation levels. CONCLUSION: Given the drawbacks of other forms of anticoagulation, and within the constraints of available data, LMWH appears--when administered with caution--to be an acceptable alternative in pregnant women with prosthetic heart valves.
Authors:
Laurence M Descarries; Line Leduc; Paul Khairy; Lise-Andrée Mercier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  15     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-10-18     Completed Date:  2007-06-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  679-85     Citation Subset:  IM    
Affiliation:
Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticoagulants / adverse effects,  therapeutic use*
Antifibrinolytic Agents / antagonists & inhibitors
Aortic Valve / surgery
Aspirin / therapeutic use
Biological Markers / blood
Coronary Artery Disease / etiology
Drug Therapy, Combination
Embolism / etiology
Female
Fibrinolytic Agents / therapeutic use
Heart Valve Diseases / drug therapy,  surgery
Heart Valve Prosthesis* / adverse effects
Heparin, Low-Molecular-Weight / adverse effects,  therapeutic use*
Humans
International Normalized Ratio
Mitral Valve / surgery
Myocardial Infarction / etiology
Pregnancy
Pregnancy Complications, Cardiovascular / etiology
Quebec
Treatment Outcome
Vitamin K / antagonists & inhibitors
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Antifibrinolytic Agents; 0/Biological Markers; 0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; 12001-79-5/Vitamin K; 50-78-2/Aspirin

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


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