scholarly journals The effect of warfarin dosage on maternal and fetal outcomes in pregnant women with prosthetic heart valves

2011 ◽  
Vol 4 (1) ◽  
pp. 24-27 ◽  
Author(s):  
P Soma-Pillay ◽  
Z Nene ◽  
T M Mathivha ◽  
A P Macdonald
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Maternal Death ◽  
Heart Valves ◽  
Warfarin Dose ◽  
Mechanical Heart Valves ◽  
Prosthetic Heart Valves ◽  
Warfarin Dosage ◽  
Valve Thrombosis ◽  
In Pregnancy

There are several challenges in the management of pregnant women with mechanical heart valves. Pregnancy increases the risk of thromboembolism and there is currently no consensus on the safest anticoagulation method during pregnancy. The objective of the study was to determine the correlation between the warfarin dose and pregnancy outcome in pregnant women with prosthetic heart valves. Warfarin in pregnancy was associated with a low risk of valve thrombosis or maternal death. The risk for fetal abnormalities was not related to the maternal warfarin dosage. However, the risk for stillbirth was significantly increased with increasing doses of warfarin.

scholarly journals DILEMMAS IN MANAGEMENT OF PREGNANT PATIENTS WITH MECHANICAL PROSTHETIC VALVES IN RURALAND SEMI-URBAN NORTH INDIAN POPULATION AT A TERTIARY CARE INSTITUTION.

2020 ◽  
pp. 44-45
Author(s):  
Amrit Gupta ◽  
Varuna Varma ◽  
Indrani Ghosh ◽  
Nirmal Kumar Gupta ◽  
Neeraj Kumar
Keyword(s):  
Pregnant Women ◽  
Heart Valves ◽  
Economic Status ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Mechanical Heart Valves ◽  
Successful Outcome ◽  
Congenital Defects ◽  
Care Hospital ◽  
In Pregnancy

Pregnancy is a prothrombotic stage, and in women with mechanical heart valves, anticoagulation is a challenge to attain an optimal outcome in mother and fetus. The use of combinations coumadin derivatives and various heparins is still in inconclusive stage due to various socioeconomic and demographic situation. In developing countries due to the cost of surgery, and compliance with lifelong anticoagulation there is contradiction for efficient outcome. Hence a safe protocol is necessary for implementation. Objectives: To evaluate the most effective, practical and uniform “Anticoagulation Regimen” suited to rural and semi-urban Indian pregnant women with mechanical heart valves with low socio-economic status and to observe its impact on the pregnancy outcomes. Methodology: Retrospective observational cohort study carried out at tertiary institute, between July 2006 to June 2015. 69 women became pregnant during the period from 2006 to 2015 on 1 or multiple occasions. 21(30.43%) pregnancies ended in early abortions and 46 (66.7%) pregnancies were continued. Anticoagulation protocol that was followed in these women was H-A-H protocol. These pregnancies were managed by obstetric team of tertiary care hospital under same consultant. Outcome measures were analyzed. Data was expressed as mean with standard deviation or frequency with percentage as appropriate. Results: Of 292 women, who underwent valve replacement surgery, 69 pregnancies were reported during this period on 1 or multiple occasions. 46 women had successful deliveries and rest 23 had single or multiple pregnancy failure. Incidence of stillbirth in those who delivered successfully was lower (2.89%). Fetal morbidity was 37.68% and none of the pregnant women had valve thrombosis. In 46 women majority had successful outcome except 6(13.04%) children out of 46 who developed anticoagulation related congenital defects. This was mainly seen in those women who presented late in pregnancy. Conclusion: Our Experience showed that Heparin-Acitrome-Heparin protocol is effective and safe in pregnancy than heparin alone, or acitrome alone regimen. The fetal outcome was good, maternal compliance was better and this protocol is widely recommended.

MECHANICAL HEART VALVES AND PREGNANCY

2007 ◽  
Vol 18 (4) ◽  
pp. 311-331 ◽  
Author(s):  
CYNTHIA MAXWELL ◽  
MATHEW SERMER
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Heart Valves ◽  
First Trimester ◽  
Mechanical Heart Valves ◽  
Low Molecular Weight ◽  
Valve Thrombosis ◽  
First Trimester Of Pregnancy ◽  
Primary Agent ◽  
In Pregnancy

Mechanical heart valves pose a particular challenge in pregnancy, as the primary agent used to prevent valve thrombosis, coumadin (warfarin), is a known teratogen. Alternatives to coumadin, such as unfractionated heparin (UFH) and low-molecular weight heparin (LMWH) are safer for the fetus, particularly during the first trimester of pregnancy, but expose the mother to potential valve failure. This review will examine these controversies and the complex literature regarding management in pregnancy.

scholarly journals Support, Access and Antenatal Care to Women with a history of Preeclampsia in Pregnancy

2020 ◽  
Vol 11 (2) ◽  
pp. 86
Author(s):  
Evi Diliana Rospia ◽  
Andari Wuri Astuti ◽  
Retno Mawarti
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Maternal Death ◽  
Information Search ◽  
Health Workers ◽  
Qualitative And Quantitative ◽  
Lack Of Information ◽  
Need Support ◽  
History Of ◽  
In Pregnancy

Preeclampsia and eclampsia are the second direct cause of maternal death worldwide, estimated to complicate 2-8% of all pregnancies, the global prevalence of preeclampsia is around 4.6%. The purpose of this scoping review is to provide an overview of studies related to antenatal support, access and services to mothers with a history of preeclampsia in pregnancy. The authors identify studies that explain preeclampsia in pregnancy from several databases namely PubMed, ProQuest, EBSCO and Springer Link. Searches are limited to studies published in English and present data for the 2009-2019 period. The identified study was reviewed using PRISMA Flowchart. Studies with qualitative and quantitative designs that explore the experiences of pregnant women regarding antenatal support, access and services were selected for review, while studies that were not experience related to antenatal support, access and services to mothers with a history of preeclampsia in pregnancy were excluded. A total of twelve articles were reviewed which obtained three sub-themes of support, namely the support of husband, family and health workers, from the theme of access obtained three sub-themes namely information search, modification programs and the availability of health workers. From the theme of antenatal care, four sub-themes are found, namely unsustainable care, lack of information, screening and feeling empowered. Pregnant women with preeclampsia need support from a partner or family and health workers. Information and screening need to be improved in antenatal care.

scholarly journals Prosthetic heart valves in pregnancy: a systematic review and meta-analysis protocol

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Claire M Lawley ◽  
Samantha J Lain ◽  
Charles S Algert ◽  
Jane B Ford ◽  
Gemma A Figtree ◽  
...  
Keyword(s):  
Systematic Review ◽  
Heart Valves ◽  
Meta Analysis ◽  
Prosthetic Heart Valves ◽  
Analysis Protocol ◽  
In Pregnancy

Heart disease in pregnancy

2012 ◽  
Keyword(s):  
Heart Disease ◽  
Heart Valves ◽  
Mechanical Heart Valves ◽  
Physiological Changes ◽  
Basic Principles ◽  
Changes In Pregnancy ◽  
Physiological Changes In Pregnancy ◽  
Heart Disease In Pregnancy ◽  
Valve Lesions ◽  
In Pregnancy

Basic principles 674Physiological changes in pregnancy 676Normal findings in pregnancy 678General considerations in pregnancy 680Pulmonary hypertension and pregnancy 682Marfan syndrome and pregnancy 683Valvular heart disease in pregnancy 684Mitral stenosis and pregnancy 686Other valve lesions 687Mechanical heart valves in pregnancy ...

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