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Mechanical heart valves increase pregnancy risk
Date:9/2/2014

ncy. Nearly 16% of women had a miscarriage before 24 weeks of pregnancy while 2.8% of women lost the foetus after 24 weeks. Haemorrhagic events occurred in 23% of women and thrombotic events in 6.1%.

Professor Roos-Hesselink said: "Pregnant women with mechanical valve prostheses are at particularly high risk of thrombotic complications, of which thrombosis of the mechanical valve is very serious and occurred in 10 patients (4.7%). They also have a significantly higher mortality (1.4%) during pregnancy compared to the other women with heart disease in the registry (0.2%)."

The researchers found that just 80% of women with a mechanical valve had a live birth. This was significantly lower than the proportion of live births in women in the registry with a tissue valve (98%) or with no prosthetic valve (98%).

A variety of anticoagulation regimes were used during the trimesters of pregnancy (<14 weeks, 14 to 36 weeks, 36 weeks to delivery). The most popular regime, used in 43% of women, was heparin followed by a vitamin K antagonist (VKA), followed by heparin. A further 21% of women were given heparin during all three trimesters, while 20% of women received a VKA during the first two trimesters and heparin in the third (1). The latter regime was associated with significantly higher late foetal mortality (16%) than the other two regimes (approximately 3%).

Professor Roos-Hesselink said: "Effective anticoagulation is essential to prevent thrombotic complications and mortality in pregnant women with mechanical heart valves. However, this inevitably carries an increased risk of haemorrhagic events, particularly during delivery. We found that if vitamin K antagonists are used for anticoagulation in the first trimester there is a significantly increased of late foetal loss. There was no clear difference between the three most common anticoagulation regimes in haemorrhagic and thrombotic complications."

She added: "Pregnancy can be a
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Contact: ESC Press Office
press@escardio.org
34-670-521-210
European Society of Cardiology
Source:Eurekalert

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