Anticoagulation therapy during pregnancy in patients with prosthetic heart valves

doi:10.3969/j.issn.1006-7795.2015.03.005

Abstract

Abstract:

Anticoagulation therapy during pregnancy is critical to both mother with prosthetic heart valves and fetus. Warfarin offers the best maternal protection against thrombosis, but it might be associated with a high risk of fetal malformations and pregnancy loss. Heparin derivatives are associated with a reduced risk of fetal damage, but an increased risk of valve thrombosis in the mother. The risk of warfarin-related embryopathy might be dose-related.The use of warfarin throughout pregnancy for those patients at the greatest risk of thromboembolism is feasible.And the patient's preferences should also be take into account.

Key words: prosthetic heart valves, pregnancy, warfarin, anticoagulation

CLC Number:

R542

Wang Jun, Lyu Yingxin, Zhang Haibo. Anticoagulation therapy during pregnancy in patients with prosthetic heart valves[J]. Journal of Capital Medical University, 2015, 36(3): 360-363.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2015.03.005

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2015/V36/I3/360

References

[1] Hall J G. Embryopathy associated with oral anticoagulant therapy[J]. Birth Defects Orig Artic Ser, 1965, 12(5): 33-37.
[2] Di Saia P J. Pregnancy and delivery of a patient with a Starr-Edwards mitral valve prosthesis: report of a case [J]. Obstet Gynecol, 1966, 28:469-472.
[3] Castellano J M, Narayan R L, Vaishnava P. Anticoagulation during pregnancy in patients with a prosthetic heart valve[J]. Nat Rev Cardiol, 2012, 9(7):415-424.
[4] European Society of Gynecology. ESC guidelines on the management of cardiovascular diseases during pregnancy: The Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2011, 32:3147-3197.
[5] Guyatt G H, Akl E A, Crowther M, et al. Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J]. Chest, 2012, 141 (Suppl 2): 7-47.
[6] Bonow R O, Carabello B A, Chatcerice K, et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons[J]. J Am Coll Cardiol, 2008, 52(13):e1-e142.
[7] 中华医学会心血管病学分会, 中国老年学学会心脑血管病专业委员会. 华法林抗凝治疗中国专家共识[J].中华内科杂志,2013, 52(1):76-82.
[8] Chan W S, Anand S, Ginsberg S, et al. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature[J]. Arch Intern Med,2000,160(12):191-196.
[9] Arnaout M S, Kazma H, Khalil A, et al. Is there a safe anticoagulation protocol for pregnant women with prosthetic valves? [J]. Clin Exp Obstet Gynecol,1998,25(3):101-104.
[10] Vitale N, De Feo M, De Santo L S, et al. Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves[J]. J Am Coll Cardiol,1999, 33(1):1637-1641.
[11] Meschengieser S S, Fondevila G G, Samtarallis M T, et al. Anticoagulation in pregnant women with mechanical heart valve prostheses[J]. Heart, 1999,82:23-26.
[12] Lee J H, Park N M, Keum D Y, et al. Low molecular weight heparin treatment in pregnant women with a mechanical heart valve prosthesis[J]. J Korean Med Sci, 2007,22(2):258-261.
[13] Nassar A H, Hobeika E M, Abd Essamad H M, et al. Pregnancy outcome in women with prosthetic heart valves[J]. Am J Obstet Gynecol,2004,191(3):1009-1013.
[14] Kawamata K, Neki A, Yamanakaк, et al. Risks and pregnancy outcome in women with prosthetic mechanical heart valve replacement[J]. Circ J,2007,71(2):211-213.
[15] Izaguirre R, De La Pera A, Rumire A, et al. Anti-Xa activity with low-molecular-weight heparin, enoxaparin, during pregnancy in women with mechanical heart valves[J]. Proc West Pharmacol Soc,2002,45:127-128.
[16] Vitale N, De Feo M, De Santo L S, et al. Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves[J]. JACC, 1999,33(6):1637-1641.
[17] Vitale N, De Feo M,Cotrufo M. Anticoagulation for prosthetic heart valves during pregnancy: the importance of warfarin daily dose[J]. Eur J Cardiothorac Surg,2002, 22(4):656.
[18] Cotrufo M, De Feo M, De Santo L S, et al. Risk of warfarin during pregnancy with mechanical valve prostheses[J]. Obstet Gynecol,2002, 99(1):35-40.
[19] Soma-Pillay P, Nene Z, Mathivha T M, et al. The effect of warfarin dosage on maternal and fetal outcomes in pregnant women with prosthetic heart valves[J]. Obstet Med,2011,4:24-27.
[20] 孟旭,李金钟,刘岩,等.人工机械瓣膜置换术后口服抗凝药的抗凝治疗强度标准[J].中华心血管杂志,2004,32(7):618-621.
[21] Lam M P, Cheung B M. The pharmacogenetics of the response to warfarin in Chinese [J].Br J ClinPharmacol, 2012, 73(3): 340-347.
[22] 娄莹,华潞,韩璐璐,等. 中国汉族人群华法林稳定剂量预测模型的建立与验证[J]. 中华心血管病杂志, 2014,42(5):384-348.
[23] 董力,刘兴会,石应康, 等. 心脏机械瓣膜置换术后妊娠妇女低强度华法林抗凝治疗56例[J].中华胸心血管外科杂志, 2011, 27(1): 8-10.
[24] Haibo Z, Jinzhong L, Yan L, et al. Low-intensity international normalized ratio (INR) oral anticoagulant therapy in Chinese patients with mechanical heart valve prostheses[J].Cell Biochem Biophys,2012,62(1):147-151.
[25] 杨光,段恋,孙英贤,等.房间隔缺损封堵术后低分子肝素应用时间对血小板的影响[J]. 中国医科大学学报,2013,42(6):529-531.
[26] 薛军,彭齐,陈晓英,等.CYP2C9基因突变与心脏瓣膜置换术后华法林初始剂量的相关性研究[J]. 解放军医药杂志,2014,26(12):21-23.
[27] 陈卫民,吴先球,王奇,等.心脏瓣膜置换术后左室破裂七例分析[J]. 临床误诊误治,2012,25(6):37-39.