PMID- 11826815
OWN - NLM
STAT- MEDLINE
DCOM- 20020225
LR  - 20061115
IS  - 0300-5860 (Print)
IS  - 0300-5860 (Linking)
VI  - 90 Suppl 6
DP  - 2001
TI  - [Anticoagulation of pregnant women with mechanical heart valve prostheses].
PG  - 125-30
AB  - Patients with a mechanical heart valve prosthesis (MHVP) are usually 
      anticoagulated with oral anticoagulants (OAC) to prevent thromboembolic 
      complications. Considering the paucity of published data, the management of women 
      with MHVP of childbearing age, who wish to become pregnant, still remains 
      difficult and complicated. OAC may cause embryopathy during the first trimester, 
      while neurologic complications, stillbirth and fetal death may appear during the 
      second and third trimester. While the application of unfractionated heparin (UFH) 
      in pregnant patients with MHVP may fail to prevent thromboembolic complications 
      even with therapeutic dosage, only little is known about the application of body 
      weight adjusted therapeutic dosages of low molecular weight heparin (LMWH). We 
      report on 8 female patients, 7 with MHVP, one with atrial fibrillation, who were 
      treated with LMWH during the whole pregnancy. No malformations or major bleeding 
      complications were observed, no valve thrombosis or thromboembolic complications 
      occurred. Three patients developed moderate heart failure during the third 
      trimester, which resolved after treatment. In three patients, cesarean section 
      was necessary, while the other five patients delivered spontaneously. Therefore, 
      anticoagulation with body weight adjusted LMWH seems to be an alternative, safe 
      and efficient treatment for pregnant women with MHVP. Prospective, randomized 
      studies are needed to further evaluate this new therapeutic approach. The 
      underlying heart disease represents a serious comorbid condition that requires 
      continuous interdisciplinary monitoring.
FAU - Lindhoff-Last, E
AU  - Lindhoff-Last E
AD  - Medizinische Klinik I Schwerpunkt Angiologie Universitatsklinik Frankfurt 
      Theodor-Stern-Kai 7 60590 Frankfurt/Main, Germany. 
      Lindhoff-Last@em.uni-frankfurt.de
FAU - Schinzel, H
AU  - Schinzel H
FAU - Erbe, M
AU  - Erbe M
FAU - Schachinger, V
AU  - Schachinger V
FAU - Bauersachs, R
AU  - Bauersachs R
LA  - ger
PT  - Comparative Study
PT  - English Abstract
PT  - Journal Article
TT  - Antikoagulation in der Schwangerschaft bei mechanischem Herzklappenersatz.
PL  - Germany
TA  - Z Kardiol
JT  - Zeitschrift fur Kardiologie
JID - 0360430
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Administration, Oral
MH  - Adult
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Cesarean Section
MH  - Female
MH  - Fibrinolytic Agents/*administration & dosage/*therapeutic use
MH  - *Heart Valve Prosthesis/adverse effects
MH  - Heparin/administration & dosage/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/administration & dosage/*therapeutic use
MH  - Humans
MH  - Infant, Newborn
MH  - Pregnancy
MH  - Pregnancy Complications, Cardiovascular/*drug therapy
MH  - Thromboembolism/etiology/prevention & control
MH  - Time Factors
EDAT- 2002/02/06 10:00
MHDA- 2002/02/28 10:01
CRDT- 2002/02/06 10:00
PHST- 2002/02/06 10:00 [pubmed]
PHST- 2002/02/28 10:01 [medline]
PHST- 2002/02/06 10:00 [entrez]
PST - ppublish
SO  - Z Kardiol. 2001;90 Suppl 6:125-30.