Maternal complications and pregnancy outcome in women with mechanical prosthetic heart valves treated with enoxaparin

摘要

Anticoagulation therapy is recommended throughout pregnancy for women with mechanical heart valves, to reduce the risk of thromboembolic complications. Although warfarin is the preferred therapeutic agent for such patients when not pregnant, warfarin is teratogenic; during pregnancy, unfractionated or low molecular weight heparin (LMWH) may be considered because it is safer for the fetus, although it is not clear that it provides adequate anticoagulation. A large number of studies have reported a wide variation (3.9%-22%) in the percentage of thrombotic complications reported in pregnant women with mechanical heart valves managed with LMWH (enoxaparin), although most studies were small. When analysis was limited to studies including 5 or more pregnancies, a rate of 6.9% was reported.