Mechanical heart valve thrombosis during pregnancy under non
10.11817/j.issn.1672-7347.2021.200645
- Author:
Jian HUANG
1
;
Yihan LIU
2
Author Information
1. Department of Gynecology and Obstetrics, Second Xiangya Hospital, Central South University, Changsha 410011. huangjian2566@csu.edu.cn.
2. Xiangya School of Medicine, Central South University, Changsha 410013, China.
- Publication Type:Review
- Keywords:
anticoagulation therapy;
heparin;
mechanical heart valve;
pregnancy;
vitamin-K antagonists
- MeSH:
Anticoagulants/adverse effects*;
Female;
Heart Valve Prosthesis/adverse effects*;
Heart Valves;
Heparin, Low-Molecular-Weight/adverse effects*;
Humans;
Pregnancy;
Pregnancy Complications, Cardiovascular/drug therapy*;
Thrombosis/drug therapy*
- From:
Journal of Central South University(Medical Sciences)
2021;46(2):207-211
- CountryChina
- Language:English
-
Abstract:
Anticoagulation drugs should be used for patients with mechanical heart valve (MHV) in case of potential risk of thrombosis. Pregnant women with MHV have to change therapies due to teratogenic effect of some anti-coagulation drugs. European Society of Cardiology clinical guidelines for the management of cardiovascular diseases during pregnancy gives specific suggestions for anticoagulation therapy.We have treated 2 patients with mechanical heart valve thrombosis (MVT) during pregnancy: One received low molecular weight heparin (LMWH) throughout the pregnancy and developed MVT at the third trimester of pregnancy; one developed MVT at the first trimester when replacing vitamin K antagonists (VKA) with LMWH. These patients raised secondary reflection on the balance between clinical guideline and personalized medicine. During LMWH therapy, we should dynamically monitor patients' anti-activated factor X (anti-Xa) level to evaluate coagulation function during pregnancy. When a pregnant woman with MHV develops symptoms of acute heart failure, stuck mechanical valve should be paid attention to and surgery should be promptly performed if necessary.
