Lutz D J, Noller K L, Spittell J A, Danielson G K, Fish C R
Am J Obstet Gynecol. 1978 Jun 15;131(4):460-8. doi: 10.1016/0002-9378(78)90423-4.
Approximately 100 cases of pregnancy in women with cardiac valve prostheses have been reported in the world's medical literature. In most instances, the need for continuous anticoagulation therapy constituted a major concern in the obstetric management of these high-risk pregnancies, particularly since coumarin has been implicated as causing an increased frequency of fetal wastage or birth defects (or both). Of all women who received cardiac valve prostheses at the Mayo Clinic between 1965 and 1975, 23 conceived 40 times after the procedure. Fetal wastage was more than doubled in women receiving coumarin therapy at conception and during the first trimester, as compared with that in women not receiving coumarin therapy. Fetal wastage exceeded 80% in women with multiple-valve prostheses who received coumarin therapy throughout early pregnancy. There were no serious maternal sequelae in any of the women. One infant of a mother receiving anticoagulation therapy had mild nasal hypoplasia, but there were no other congenital anomalies in which coumarin had been previously implicated.
世界医学文献中已报道了约100例心脏瓣膜置换术后妊娠的病例。在大多数情况下，对于这些高危妊娠的产科管理而言，持续抗凝治疗的必要性是一个主要问题，尤其是因为香豆素被认为会导致胎儿流产或出生缺陷（或两者兼有）的频率增加。在1965年至1975年间于梅奥诊所接受心脏瓣膜置换术的所有女性中，有23人在术后怀孕40次。与未接受香豆素治疗的女性相比，在受孕时及孕早期接受香豆素治疗的女性胎儿流产率增加了一倍多。在整个孕早期接受香豆素治疗的多瓣膜置换女性中，胎儿流产率超过80%。所有这些女性均未出现严重的母体后遗症。一名接受抗凝治疗的母亲所生婴儿有轻度鼻发育不全，但没有其他先前认为与香豆素有关的先天性异常。
