Document Detail

Risks and pregnancy outcome in women with prosthetic mechanical heart valve replacement.
MedLine Citation:
PMID:  17251669     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pregnancy after mechanical heart valve replacement is highly risky for both mother and child because of the aggravation of maternal heart function and adverse effects of anticoagulation therapy. In Japan, however, the risks and pregnancy outcomes in women with prosthetic mechanical heart valve replacement remain to be elucidated. METHODS AND RESULTS: In the present study 16 pregnancies in 12 women with prosthetic mechanical heart valve replacement were identified between 1983 and 2005. At 6-13 weeks of gestational age, warfarin, an anticoagulant agent, was changed to heparin and administration was continuously adjusted according to the activated partial thromboplastin time level up to the time of delivery. Major maternal complications and pregnancy outcomes were retrospectively investigated. The valve replaced was mitral (n=7), tricuspid (n=7), and aortic (n=2). Eight (50%) of 16 had cesarean live births. One case was delivered at full term, and 7 cases were delivered preterm (26-36 weeks) because of maternal indications. Two babies died in the neonatal period. Therapeutic abortion was performed in 3 cases, 4 cases ended in early miscarriage, and 1 case ended in intrauterine fetal death (30 weeks). Three mothers developed valve (mitral, tricuspid, aortic) thrombosis. There was 1 maternal death from heart failure. CONCLUSIONS: Pregnancy after mechanical heart valve replacement requires strict control of coagulation. Special attention should be paid to the occurrence of complications during anticoagulation therapy.
Kazuya Kawamata; Reiko Neki; Kaoru Yamanaka; Shiho Endo; Hirotugu Fukuda; Tomoaki Ikeda; Tsutomu Douchi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  71     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-25     Completed Date:  2007-04-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  211-3     Citation Subset:  IM    
Department of Perinatology, National Cardiovascular Center, Suita, Japan.
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MeSH Terms
Anticoagulants / adverse effects,  therapeutic use
Heart Valve Prosthesis / adverse effects*
Heparin / adverse effects,  therapeutic use
Pregnancy Complications, Cardiovascular / etiology*,  prevention & control
Pregnancy Complications, Hematologic / etiology*,  prevention & control
Pregnancy Outcome*
Retrospective Studies
Risk Factors
Thromboembolism / etiology,  prevention & control
Reg. No./Substance:
0/Anticoagulants; 9005-49-6/Heparin

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