Publication:

Successful maternal and fetal outcome of pregnancy following heart valve replacement using a sequential anti coagulation regime

Background Patients with mechanical heart valves require anticoagulation which is associated with significant maternal mortality (1-4%) and fetal complications (31%) in pregnancy.

Methods A prospective study was carried out enrolling  pregnant patients with mechanical heart valves who were booked at our institution for antenatal care, managed using a sequential  anticoagulant regime consisting of warfarin and low molecular weight heparin and delivered at our utility over two years.

Results We had seven cases of pregnancy following heart valve replacement over a period of two years with no fetal malformations and successful maternal outcome (71.43% term deliveries).

Conclusions LMWH until 13th week of gestation, followed by warfarin until late third trimester (36 weeks), then restarting LMWH until delivery in pregnant patients with mechanical heart valves was associated with successful maternal and fetal outcome.