Pharmaceutical care for a patient with missed abortion after aortic mechanical valve replacement surgery
- VernacularTitle:1例主动脉机械瓣置换术后合并稽留流产患者的药学监护实践
- Author:
Huan CHEN
1
;
Baian WANG
1
;
Qingqing DU
2
;
Yao MU
1
Author Information
1. Dept. of Pharmacy，Fuling Hospital Affiliated to Chongqing University，Chongqing 408000，China
2. Dept. of Pharmacy，The Second Affiliated Hospital of Chongqing Medical University，Chongqing 400010，China
- Publication Type:Journal Article
- Keywords:
aortic mechanical valve replacement surgery;
missed abortion;
anticoagulant therapy;
medical abortion;
drug-drug interactions
- From:
China Pharmacy
2026;37(13):1751-1754
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide a reference for anticoagulant therapy and vaginal bleeding management during medical abortion in patients with missed abortion after aortic mechanical valve replacement surgery. METHODS Clinical pharmacists conducted pharmaceutical monitoring on a patient with missed abortion after aortic mechanical valve replacement surgery， and analyzed the correlation between warfarin use and abortion. In response to gingival bleeding and an increase in the international normalized ratio （INR） after taking mifepristone， clinical pharmacists recommended discontinuing warfarin based on bleeding risk and INR changes； for the selection of sex hormones after missed abortion， clinical pharmacists suggested that estradiol gel combined with progesterone should be used in sequential treatment， supplemented by Xian yimucao capsules， to accelerate the elimination of residual tissue and congestion in uterine cavity. RESULTS The physician followed the advice of the clinical pharmacist and did not prolong the patient’s hospital stay due to excessive vaginal bleeding during treatment. Warfarin treatment was restarted on the day of discharge， and INR remained stable within the target anticoagulation range after discharge without any adverse events such as thromboembolism. CONCLUSIONS In patients with missed abortion after aortic valve replacement surgery， mifepristone may enhance the anticoagulant effect of warfarin and increase the risk of bleeding during medical abortion. It is recommended to discontinue warfarin before medication. Clinical pharmacists play a crucial role in the development of anticoagulation plans， identification of drug-drug interactions， assessment of bleeding risks， and selection of postoperative sex hormones. Through full pharmaceutical monitoring， they ensure the safety of patients’ medication.
