Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.
Am J Obstet Gynecol. 2022 Aug;227(2):B28-B43. doi: 10.1016/j.ajog.2022.03.036. Epub 2022 Mar 22.
Pregnancy in individuals with a mechanical heart valve has been classified as very high risk because of a substantially increased risk of maternal mortality or severe morbidity. Lifelong therapeutic anticoagulation is a principal component of the medical management of mechanical heart valves to prevent valve thrombosis. Anticoagulation regimens indicated outside of pregnancy for patients with mechanical valves should be continued during pregnancy with the possibility of modifications based on the type of valve, the trimester of pregnancy, individual risk tolerance, and circumstances around the time of delivery. The purpose of this document is to provide recommendations regarding the management of anticoagulation for common cardiac conditions complicating pregnancy, including mechanical heart valves, atrial fibrillation, systolic heart failure, and congenital heart disease.
患有机械心脏瓣膜的个体妊娠被归类为极高风险，因为母亲死亡率或严重发病率显著增加。终身治疗抗凝是机械心脏瓣膜医学管理的主要组成部分，以防止瓣膜血栓形成。机械心脏瓣膜患者妊娠期间应继续使用抗凝方案，可根据瓣膜类型、妊娠阶段、个体风险耐受度和分娩前后情况进行调整。本文件的目的是提供有关妊娠合并常见心脏疾病（包括机械心脏瓣膜、心房颤动、收缩性心力衰竭和先天性心脏病）抗凝管理的建议。
