患有人工心脏瓣膜的产科患者。
The obstetrical patient with a prosthetic heart valve.
作者信息
Danik Stephan, Fuster Valentin
机构信息
Zena and Michael A. Weiner Cardiovascular Institute, Box 1030, Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029, USA.
出版信息
Obstet Gynecol Clin North Am. 2006 Sep;33(3):481-91. doi: 10.1016/j.ogc.2006.05.001.
Definitive recommendations on anticoagulation strategy in pregnant women who have prosthetic heart valves are lacking because of the paucity of prospectively collected data. The use of warfarin, UFH, LMWH, or any combination of these choices has potentially adverse outcomes for the mother and fetus. Although there is no treatment option that has proven to be completely satisfactory, there is agreement that failures are most often due to underdosing and the lack of intensive monitoring of anticoagulation. A careful discussion with the patient must be undertaken so that she and the clinician can come to a decision about the most appropriate protocol.
由于前瞻性收集的数据匮乏，对于患有人工心脏瓣膜的孕妇的抗凝策略，目前缺乏明确的建议。使用华法林、普通肝素（UFH）、低分子肝素（LMWH）或这些选择的任何组合，对母亲和胎儿都可能产生不良后果。尽管没有一种治疗方案已被证明是完全令人满意的，但人们一致认为，治疗失败最常见的原因是剂量不足以及缺乏对抗凝的密切监测。必须与患者进行仔细的讨论，以便她和临床医生能够就最合适的方案做出决定。
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