Document Detail


Pregnancy and mechanical heart valves replacement; dilemma of anticoagulation.
MedLine Citation:
PMID:  12142189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To establish a uniform anticoagulation regimen for pregnant patients with mechanical heart valves taking into account the socio-economic background and to evaluate the incidence of anticoagulant related complications. METHODS: A retrospective study on 63 pregnancies in 21 women with mechanical heart valves was evaluated. These pregnancies were divided into two groups: Group I (n=42) received oral anticoagulants throughout pregnancy and Group II (n=21) received subcutaneous heparin in the 1st trimester and oral anticoagulants for the rest of pregnancy period. Both groups received heparin at time of delivery. RESULTS: There was no case of coumarin embryopathy seen and there was no maternal death. Life threatening valve thrombosis occurred in two patients who were both from Group II and needed emergency re-replacement. Group I had a higher incidence of spontaneous abortion than Group II although this was not statistically significant. CONCLUSIONS: The role of coumarin embryopathy has been overstated. We recommend the use of oral anticoagulants throughout pregnancy especially in countries with similar socio-economic background.
Authors:
Adil A M Al-Lawati; M Venkitraman; Taha Al-Delaime; John Valliathu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  22     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-26     Completed Date:  2002-11-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  223-7     Citation Subset:  IM    
Affiliation:
Cardiothoracic Surgery Unit, Royal Hospital Muscat, Sultanate of Oman, PO Box 225, Code 115, Muscat, Oman. adilawati@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Anticoagulants / administration & dosage*
Coumarins / administration & dosage*
Drug Administration Schedule
Female
Heart Valve Prosthesis*
Heparin / administration & dosage*
Humans
Injections, Subcutaneous
Pregnancy
Pregnancy Complications, Cardiovascular / drug therapy*
Pregnancy Outcome
Retrospective Studies
Risk Factors
Thrombosis / epidemiology,  prevention & control*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Coumarins; 9005-49-6/Heparin; 91-64-5/coumarin

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


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