Influence of heart-valve replacement of warfarin anticoagulant therapy on perinatal outcomes.

OBJECTIVE

To explore the influence of the single use of perinatal warfarin anticoagulation therapy on pregnancy outcome after the mechanical heart-valve replacement surgery in pregnant women.

METHODS

Fifty-eight cases of pregnant women after heart-valve replacement surgery (2005.1-2009.12) received low-dose warfarin anticoagulation therapy. The perinatal outcomes included: (1) maternal complications: thrombosis, hemorrhage, heart failure, etc., and (2) adverse perinatal outcomes: miscarriage, stillbirth, neonatal death, fetal malformation, preterm delivery, such as warfarin syndrome.

RESULTS

In 58 patients, valve thrombosis was found in one case of pregnancy, general hemorrhage was found in 16 cases, spontaneous abortion was found in two cases, malformation was found in two cases. There were no stillbirth and neonatal death. Three cases were premature delivery. Thirty-two of 56 cases were late pregnancy vaginal delivery. Twenty-four cases were cesarean section produced, in which heart failure happened in 1 case and late postpartum hemorrhage happened in one case.

CONCLUSION

The low-dose and low-intensity warfarin anticoagulation therapy during pregnancy is good for patients with good compliance and low rate of fetal malformations and can effectively prevent maternal complications.