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[心脏瓣膜置换术后孕妇抗凝剂的使用]

[Use of anticoagulants in pregnant women carrying heart valve prosthesis].

作者信息

Dattino R, Niccoli V, Silvestri C, Dattino M

出版信息

Clin Ter. 1989 Mar 31;128(6):401-4.

PMID:2524326
Abstract

Prosthetic heart valves require permanent anticoagulant treatment. In the case of pregnancy, serious problems arise in that coumarin drugs lead to increased incidence of fetal death and malformation. On the other hand, the omission of anticoagulant treatment implies considerable risks of systemic embolism and even of maternal death. Review of the literature and the few cases published so far do not prove that antiplatelet agents are effective and safe and offer sufficient protection against thromboembolism. The use of heparin may reduce the incidence of complications. The authors come to the conclusion that women with prosthetic heart valves should be advised to avoid pregnancy. Biovalves should be applied in those who wish to bear children.

摘要

人工心脏瓣膜需要进行长期抗凝治疗。在妊娠情况下,会出现严重问题,因为香豆素类药物会导致胎儿死亡和畸形的发生率增加。另一方面,不进行抗凝治疗意味着存在发生全身性栓塞甚至孕产妇死亡的重大风险。对文献的回顾以及目前已发表的少数病例并未证明抗血小板药物是有效且安全的,也不能提供足够的抗血栓栓塞保护。使用肝素可能会降低并发症的发生率。作者得出结论,应建议有人工心脏瓣膜的女性避免怀孕。对于希望生育的女性应使用生物瓣膜。

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