Warfarin embryopathy: Balancing maternal and fetal risks with anticoagulation therapy

Ferreira, Sara Tavares; Costa, Raquel; Malveiro, Duarte; Vieira, Filipa; Tuna, Madalena

doi:10.1016/j.pedneo.2018.02.005

Cited by 5 publications

(2 citation statements)

References 3 publications

(2 reference statements)

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“…In general, the European Society of Cardiology recommends ceasing warfarin at gestational weeks 6-12 and continuing anticoagulation therapy with heparin. 12,17 The fetal outcome heavily depends on timing of exposure during the pregnancy. Exposure during the first trimester can cause warfarin embryopathy (also called warfarin congenital syndrome), in which the fetus presents with nasal bone hypoplasia and stippling of Copyright © ASAIO 2023…”

Section: Anticoagulationmentioning

confidence: 99%

Pumping for Two: Pregnancy in Patients Supported With a Left Ventricular Assist Device

Oren,

Moeller,

Haythe

et al. 2023

ASAIO Journal

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This review discusses the challenges and outcomes associated with pregnancy during left ventricular assist device (LVAD) support. Women account for a third of the heart failure population in the United States. Left ventricular assist devices have emerged as a safe and effective treatment option for patients with advanced heart failure. Pregnancy during LVAD support can occur, and it presents significant risks to both mother and fetus, including hemodynamic stress, thrombotic events, medication-associated teratogenicity, and uterine impingement. This literature review identified 10 cases of confirmed pregnancy during LVAD support, of which eight resulted in successful births. Maternal and fetal mortality occurred in one case, and there was a spontaneous abortion in one case. The review highlights the importance of a multidisciplinary approach, promotion of shared decision-making, thoughtful anticoagulation, adjustment of LVAD speed, and medication optimization to maintain hemodynamic support during pregnancy. Hemodynamic changes during pregnancy include increased cardiac output, heart rate, and plasma volume, as well as decreased systemic vascular resistance, which can impact LVAD support. Despite reduced pulsatility in LVAD-supported patients, ovulation and reproductive capacity might be preserved, and viable pregnancies may be achieved with appropriate management. The review provides insights into the risks and considerations for a viable pregnancy during LVAD support, including the need for ongoing research to inform joined decision-making.

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Section: Anticoagulationmentioning

confidence: 99%

Pumping for Two: Pregnancy in Patients Supported With a Left Ventricular Assist Device

Oren,

Moeller,

Haythe

et al. 2023

ASAIO Journal

View full text Add to dashboard Cite

show abstract

“…7,18 Developing fetuses are most vulnerable to warfarin at 6 to 12 weeks of gestation because of its proposed interference with crucial steps during embryonic ossification. 19,20 The rate of warfarin embryopathy occurred in up to 29.6% of pregnancies exposed at some point in the first trimester of pregnancy 21 ; however, larger studies more consistently report rates ranging from 2% to 12%. 12,22e24 The clinical features of warfarin embryopathy include nasal hypoplasia, chondrodysplasia punctata, cardiac malformations, microcephaly, optic atrophy, blindness, deafness, and central nervous system abnormalities.…”

Section: What Anticoagulation Is Required For Pregnant Individuals Wi...mentioning

confidence: 99%

Society for Maternal-Fetal Medicine Consult Series #61: Anticoagulation in pregnant patients with cardiac disease

Pacheco

Saade

Shrivastava

et al. 2022

American Journal of Obstetrics and Gynecology

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Causes of Genetic Conditions and Laboratory and Testing Approaches

2022

Medical Genetics and Genomics

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Warfarin embryopathy: Balancing maternal and fetal risks with anticoagulation therapy

Cited by 5 publications

References 3 publications

Pumping for Two: Pregnancy in Patients Supported With a Left Ventricular Assist Device

Pumping for Two: Pregnancy in Patients Supported With a Left Ventricular Assist Device

Society for Maternal-Fetal Medicine Consult Series #61: Anticoagulation in pregnant patients with cardiac disease

Causes of Genetic Conditions and Laboratory and Testing Approaches

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