Low Molecular Weight Heparin Treatment in Pregnant Women with a Mechanical Heart Valve Prosthesis.
10.3346/jkms.2007.22.2.258
- Author:
Jae Hoon LEE
1
;
Nam Hee PARK
;
Dong Yoon KEUM
;
Sae Young CHOI
;
Ki Young KWON
;
Chi Heum CHO
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine, 194 Dongsan-dong, Joong-gu, Daegu, Korea. nhpark@dsmc.or.kr
- Publication Type:Original Article ; Controlled Clinical Trial
- Keywords:
Low Molecular Weight Heparin;
Heart Valve Prosthesis;
Pregnant Women
- MeSH:
Treatment Outcome;
Thrombosis/etiology/*prevention & control;
Pregnancy Outcome;
Pregnancy Complications, Cardiovascular/*etiology/*prevention & control;
Pregnancy;
Nadroparin/*administration & dosage/*adverse effects;
Hydrocephalus/chemically induced;
Humans;
Heart Valve Prosthesis/*adverse effects;
Heart Valve Diseases/etiology/*prevention & control;
Female;
Coumarins/administration & dosage;
Adult
- From:Journal of Korean Medical Science
2007;22(2):258-261
- CountryRepublic of Korea
- Language:English
-
Abstract:
No definitive recommendation is available concerning optimal antithrombotic therapy in pregnant women with a mechanical heart valve. The purpose of the current study was to evaluate the clinical results of nadroparin treatment with respect to pregnancy outcome and maternal complications. From 1997 to 2005, 31 pregnancies were reviewed in 25 women. Nadroparin (7,500 U, twice daily) was used in 23 pregnancies between 6 and 12 weeks of gestation and close-to-term only, and coumarin derivatives were used with aspirin at other times. Eight pregnant women treated with coumarin derivatives throughout pregnancy were compared to evaluate the safety and efficacy of nadroparin. No maternal death or bleeding complication occurred in either of the two groups, and frequencies of maternal thromboembolism including valve thrombosis (8.7% vs. 12.5%, p>0.05) were similar. However, the frequencies of live born (91.3% vs. 50%, p=0.01) and healthy babies (90.4% vs. 25%, p<0.01) were significantly higher, and the fetal loss rate was significantly lower (8.7% vs. 50%, p=0.01) in the nadroparin-treated group. Regarding the efficacy and safety of antithrombotic treatment in pregnant women with prosthetic heart valves, nadroparin treatment during the first trimester is an acceptable regimen and produces better results than coumarin derivatives.
