Wong V, Cheng C H, Chan K C
Department of Paediatrics, Queen Mary Hospital, University of Hong Kong.
Am J Med Genet. 1993 Jan 1;45(1):17-21. doi: 10.1002/ajmg.1320450107.
We studied fetal and neonatal outcome of women maintained on anticoagulants (warfarin and/or heparin) during pregnancy. Among 22 Chinese families, 13 mothers (59%) had a history of recurrent abortion or stillbirth while being maintained on warfarin treatment. Twenty-nine liveborn children (17 boys, 12 girls), ages 0.6-11.3 years at follow-up, were analysed for evidence of embryopathy. These were subdivided into 2 groups. Group 1 consisted of 18 children (12 boys, 6 girls) whose mothers were only given warfarin during pregnancy. Five were small for gestational age, and 12 had features of warfarin embryopathy such as nasal hypoplasia. One had subependymal intraventricular hemorrhage shown on neonatal ultrasonography. Group 2 consisted of 11 children (5 boys, 6 girls) whose mothers were maintained on warfarin and heparin during pregnancy. Three were premature deliveries, and 4 had nasal hypoplasia. One had cleft lip, cleft palate, cataract, microphthalmia, intraventricular hemorrhage, and hydrocephalus. We found that despite the high risk of fetal wastage, there was a relative lower risk of major complications, except for some minor cosmetic defects such as nasal hypoplasia. This might lead to readjustment of advice concerning contraception given to pregnant women who were maintained on anticoagulant therapy.
我们研究了孕期持续使用抗凝剂（华法林和/或肝素）的女性的胎儿及新生儿结局。在22个中国家庭中，13名母亲（59%）在接受华法林治疗期间有复发性流产或死产史。对29名活产儿童（17名男孩，12名女孩）进行了分析，这些儿童在随访时年龄为0.6至11.3岁，以寻找胚胎病的证据。这些儿童被分为两组。第1组由18名儿童（12名男孩，6名女孩）组成，他们的母亲在孕期仅使用了华法林。5名儿童小于孕周，12名儿童有华法林胚胎病的特征，如鼻发育不全。1名儿童在新生儿超声检查中显示有室管膜下脑室内出血。第2组由11名儿童（5名男孩，6名女孩）组成，他们的母亲在孕期同时使用了华法林和肝素。3名儿童早产，4名儿童有鼻发育不全。1名儿童有唇腭裂、白内障、小眼症、脑室内出血和脑积水。我们发现，尽管胎儿丢失风险很高，但除了一些轻微的外观缺陷如鼻发育不全外，主要并发症的风险相对较低。这可能会导致调整对接受抗凝治疗的孕妇的避孕建议。
