Gohlke-Bärwolf C, Pildner von Steinburg S, Kaemmerer H, Regitz-Zagrosek V
Herz-Zentrum Bad Krozingen, Südring 15, 79189 Bad Krozingen, Deutschland.
Internist (Berl). 2008 Jul;49(7):779-87. doi: 10.1007/s00108-008-2071-6.
A review of coagulation disturbances during pregnancy and the current management of the anticoagulated patient with heart valve prostheses, atrial fibrillation, and thromboembolic events is presented. All patients with mechanical heart valve prostheses require life-long oral anticoagulation with coumarin or one of its derivatives. Recommendations for the treatment and prevention of thromboembolic events are discussed. The advantages and disadvantages of three different treatment approaches to anticoagulation during pregnancy are discussed and recommendations for the management in different situations are outlined with delineation of specific risks for the mother and the fetus.
本文综述了妊娠期凝血功能障碍以及目前对抗凝治疗的心脏瓣膜置换患者、心房颤动患者和血栓栓塞事件患者的管理。所有机械心脏瓣膜置换患者都需要终身口服香豆素或其衍生物之一进行抗凝治疗。文中讨论了血栓栓塞事件的治疗和预防建议。讨论了妊娠期三种不同抗凝治疗方法的优缺点，并概述了不同情况下的管理建议，同时阐述了对母亲和胎儿的具体风险。
