211288 Low-intensity anticoagulation therapy in the pregnant women with mechanical heart valves:a report with 56 cases

/Dong Li(董力，Dept Cardiovascul Surg，West China Hosp，Sichuan Univ，Chengdu 610041)…∥Chin J Thorac Cardiovasc Surg.-2011，27(1).-8 ～10

ObjectiveTo evaluate the method of low-intensity anticoagulation therapy in the pregnant women who had received mechanical heart valve replacemant，and the effects of warfarin on the pregnant women and their fetus.MethodsThis retrospective study involved 56 pregnant women(61 pregnancies)who had received mechanical heart valve replacement.Their pregnant status，delivery，and anticoagulation therapy were observed and followedup between May 1986 and November 2009 at West China Hospital of Sichuan University.ResultsAll patients took oral anticoagulant(warfarin)throughout pregnancy.The dose of domestic warfarin was(3.02 ±0.85)mg/d(in 42 cases)，and the dose of imported warfarin was(2.84 ±0.57)mg/d(in 14 cases).The mean INR value of 401 samples from patients was 1.67 ±0.58.No thromboembolism or major hemorrhagic complications occurred.Minor bleeding occurred in 11 pregnancies.Forty-seven patients had term delivery，7 had premature birth，6 had spontaneous abortion，and 1 had intrauterine fetal death.Six newborns were born with low birth weight(2.3 ±0.5)kg，and no abnormal fetus was observed.ConclusionThe low-intensity anticoagulation therapy with warfarin(at a dose of less than 5 mg/d)and a INR target of 1.5 to 2.0 was safe and convenient for the pregnant women，who had received mechanical heart valve replacement.The abnormalities rate of fetus was low.12 refs.