Raivio K O, Ikonen E, Saarikoski S
Acta Paediatr Scand. 1977 Nov;66(6):735-9. doi: 10.1111/j.1651-2227.1977.tb07981.x.
Two mothers with heart valve prosthesis were treated with warfarin during pregnancy. In the first case a caesarean section was done one week after replacement of warfarin with heparin. The baby died of cerebral and pulmonary hemorrhage. The second mother had a male infant by caesarean section. The baby showed warfarin-induced embryopathy with nasal hypoplasia and stippled epiphyses (chondrodysplasia punctata). Nasal hypoplasia with or without stippled epiphyses has now been reported in 11 infants born to mothers treated with warfarin during the first trimester, and a causal association is probable. In view of the risks to both mother and fetus in women with prosthetic cardiac valves it is recommended that therapeutic abortion be advised as the first alternative.
两名心脏瓣膜置换术后的母亲在孕期接受了华法林治疗。第一例在停用华法林改用肝素一周后进行了剖宫产。婴儿死于脑和肺出血。第二位母亲剖宫产下一名男婴。该婴儿表现出华法林诱导的胚胎病，伴有鼻发育不全和骨骺点状钙化（点状软骨发育不良）。目前已有11例孕早期接受华法林治疗的母亲所生婴儿出现鼻发育不全，伴或不伴有骨骺点状钙化，很可能存在因果关系。鉴于人工心脏瓣膜女性的母亲和胎儿均面临风险，建议首选治疗性流产。
