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Pregnancy managed by unfractionated heparin after mechanical aortic valve replacement
- Source :
- The journal of maternal-fetalneonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 33(6)
- Publication Year :
- 2018
-
Abstract
- Pregnancy after mechanical valve replacement involves high risk. Maternal valve thrombosis and hemorrhagic complications are associated with lethal outcomes; therefore, strict anticoagulant therapy is needed. Our patient was 26-year-old primiparous woman. She had undergone aortic valve replacement with a mechanical valve at 4 years of age and had used warfarin 3 mg per day since then. Because of her desire for a baby, she stopped warfarin and conceived spontaneously. She was referred to our hospital. After being informed of her choices, unfractionated heparin (UFH) administration was started. She experienced mild heart failure with sacroiliitis, bacteremia, and hematuria during pregnancy. She delivered her newborn at 37 weeks. Blood loss at delivery was 220 g. Administration of UFH was restarted 4 h after delivery and 3 mg of warfarin was administered from postpartum day (PPD) 6. Hemostatic suturing was required for vaginal bleeding on PPD7. A therapeutic dose of warfarin was achieved on PPD9. Although warfarin use is recommended as anticoagulant therapy for pregnant woman with mechanical valves, the safety and efficacy of UFH have not yet been clarified because of its limited use. More cases are needed to clarify this.
- Subjects :
- Adult
Postnatal Care
medicine.medical_specialty
Valve thrombosis
Pregnancy Complications, Cardiovascular
030204 cardiovascular system & hematology
Mechanical valve
Drug Administration Schedule
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Pregnancy
medicine
Humans
Heart Valve Prosthesis Implantation
030219 obstetrics & reproductive medicine
business.industry
Heparin
Obstetrics and Gynecology
Mechanical Aortic Valve
Anticoagulants
Prenatal Care
medicine.disease
Surgery
Anticoagulant therapy
Hemorrhagic complication
Aortic Valve
Pediatrics, Perinatology and Child Health
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 14764954
- Volume :
- 33
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- The journal of maternal-fetalneonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
- Accession number :
- edsair.doi.dedup.....26aa2716ca2411682bb185160a0607ae