Pregnancy in patients with prosthetic heart valves: The effects of anticoagulation on mother, fetus, and neonate

Born, Daniel; Martinez, Eulógio E.; Almeida, Pedro Augusto Marcondes de; Santos, Dirceu V.; Carvalho, Antônio Carlos; Moron, Antônio Fernandes; Miyasaki, Celia H.; Moraes, Suzana Alves de; Ambrose, John A.

doi:10.1016/0002-8703(92)90606-v

Cited by 108 publications

(56 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12 Among 26 patients with mechanical prostheses, 4 (15.4%) had thromboembolic episodes, with 3 occurring during heparin treatment, causing one maternal death and two emergency valve replacements. These data are consistent with those of many others, 13,14 who emphasize adverse pregnancy outcomes in women with mechanical prosthetic valves, particularly during heparin use.…”

Section: Discussionsupporting

confidence: 92%

Pregnancy in patients with heart disease: Experience with 1,000 cases

Ávila

Rossi

Ramires

et al. 2003

Clinical Cardiology

230

110

View full text Add to dashboard Cite

SummaryBackground: Previously, the high maternal mortality in cardiac patients who became pregnant prompted the assertion: Women with an abnormal heart should not become pregnant. This long-standing notion needs to be revised today.Hypothesis: The study was undertaken to ascertain the experience with a large series of pregnant women with cardiac disease cared for in the same referral center.Methods: From 1989 to 1999, 1,000 pregnant women with heart disease were followed by the same clinical and obstetric team. The cardiac diseases included rheumatic heart disease (55.7%), congenital heart disease (19.1%), Chagas' disease (8.5%), cardiac arrhythmias (5.1%), cardiomyopathies (4.3%), and others (7.3%).Results: Of the pregnant women studied, 765 (76.5%) experienced no cardiovascular events during the study; 235 (23.5%) patients had the following cardiovascular complications: congestive heart failure (12.3%), cardiac arrhythmias (6%), thromboembolism (1.9%), angina (1.4%), hypoxemia (0.7%), infective endocarditis (0.5%), and other complications (0.7%). Clinical treatment allowed adequate management in 161 (68.8%) patients; however, 46 (19.6%) patients underwent interventional procedures because of refractory complications. The general maternal mortality rate was 2.7%. Of the 915 (91.5%) infants who were discharged, 119 (13%) were premature.

show abstract

Section: Discussionsupporting

confidence: 92%

Pregnancy in patients with heart disease: Experience with 1,000 cases

Ávila

Rossi

Ramires

et al. 2003

Clinical Cardiology

230

110

View full text Add to dashboard Cite

show abstract

“…Overall, about 50 % of women of childbearing age will require valve replacement 10 years after the initial operation with a bioprosthetic valve, and this risk is greatest when the bioprosthesis is in the mitral position [40]. There are conflicting data on whether there is an accelerated bioprosthetic valve degeneration during pregnancy [41][42][43][44][45][46] or whether there is just the natural deterioration of tissue valves [47,48]. Bioprosthetic valves have a low thromboembolic risk, thus avoiding the need of anticoagulation and decreasing the risk of bleeding.…”

Section: Prosthetic Valve Diseasementioning

confidence: 99%

Echocardiography in Pregnancy: Part 1

2016

View full text Add to dashboard Cite

The prevalence of pregnant women with cardiovascular heart disease is increasing. Transthoracic echocardiography is safe during pregnancy, and it is an important diagnostic tool in pregnant women with established heart disease in order to monitor ventricular and valvular anatomy and function. In addition, it can be used to delineate cardiac anatomy in complex congenital heart disease and help stratify maternal risk during pregnancy. This review will focus on the use of echocardiography in the diagnosis and management of pregnant women with common congenital lesions and with prosthetic valves.

show abstract

“…So that this patient is highly vulnerable to intracardiac thrombosis especially with the prosthetic heart valve and the patient may require surgical intervention with high fetal and maternal mortality. 5 The management of a pregnant woman with a prosthetic heart valve requires important considerations, especially when it comes to maintaining anticoagulation. Warfarin is considered to be a safe and effective anticoagulant for patients with prosthetic heart valves.…”

Section: Introductionmentioning

confidence: 99%

“…6 The risk of thromboembolism, miscarriage, and premature birth is felt to be higher in patients who have prosthetic heart valves requiring anticoagulation. 5 If open heart surgery is required, it is best undertaken in the second trimester. 7 However, this procedure is associated with high obstetric and fetal risks, with emphasis on the impact of extracorporeal circulation (ECC) and anesthetic agents.…”

Section: Introductionmentioning

confidence: 99%

Maternal and fetal outcome among pregnant women following open heart surgery

Ranjan

Akhter

Adhikary

et al. 2017

Bangabandhu Sheikh Mujib Medical University Journal

View full text Add to dashboard Cite

<p>The aim of this retrospective cohort study was to evaluate the pregnancy outcome following open heart surgery for three years. Group I (n = 37) included pregnancy with history of intracardiac repair except valvular heart disease, while Group II (n = 19) included pregnancy with prosthetic valve received anticoagulation therapy. In total, 78.6% pregnancies ended in healthy live births, and 19.6% pregnancies terminated in abortion (8.1% patients in Group I and 42.1% patients in Group II). 5.3% baby was born with congenital malformation in Group II. Mean birth weight was found 2.8 ± 0.6 kg in Group I and 2.5 ± 0.3 kg in Group II. The mean APGAR score was found 8.5 ± 0.7 in Group I and 8.1 ± 0.7 in Group II. 19.6% patients developed cardiac complications during the pregnancy. Majority of the patients (89.2% in Group I and 63.2% in Group II) was found good health status. Proper antenatal care and early risk stratification are the fundamental measures to improve the maternal and fetal outcome in a patient of open heart surgery.</p>

show abstract

Pregnancy in patients with prosthetic heart valves: The effects of anticoagulation on mother, fetus, and neonate

Cited by 108 publications

References 19 publications

Pregnancy in patients with heart disease: Experience with 1,000 cases

Pregnancy in patients with heart disease: Experience with 1,000 cases

Echocardiography in Pregnancy: Part 1

Maternal and fetal outcome among pregnant women following open heart surgery

Contact Info

Product

Resources

About