PMID- 30231658
OWN - NLM
STAT- MEDLINE
DCOM- 20201119
LR  - 20201119
IS  - 1476-4954 (Electronic)
IS  - 1476-4954 (Linking)
VI  - 33
IP  - 6
DP  - 2020 Mar
TI  - Pregnancy managed by unfractionated heparin after mechanical aortic valve 
      replacement.
PG  - 1030-1032
LID - 10.1080/14767058.2018.1512573 [doi]
AB  - Pregnancy after mechanical valve replacement involves high risk. Maternal valve 
      thrombosis and hemorrhagic complications are associated with lethal outcomes; 
      therefore, strict anticoagulant therapy is needed. Our patient was 26-year-old 
      primiparous woman. She had undergone aortic valve replacement with a mechanical 
      valve at 4 years of age and had used warfarin 3 mg per day since then. Because of 
      her desire for a baby, she stopped warfarin and conceived spontaneously. She was 
      referred to our hospital. After being informed of her choices, unfractionated 
      heparin (UFH) administration was started. She experienced mild heart failure with 
      sacroiliitis, bacteremia, and hematuria during pregnancy. She delivered her 
      newborn at 37 weeks. Blood loss at delivery was 220 g. Administration of UFH was 
      restarted 4 h after delivery and 3 mg of warfarin was administered from 
      postpartum day (PPD) 6. Hemostatic suturing was required for vaginal bleeding on 
      PPD7. A therapeutic dose of warfarin was achieved on PPD9. Although warfarin use 
      is recommended as anticoagulant therapy for pregnant woman with mechanical 
      valves, the safety and efficacy of UFH have not yet been clarified because of its 
      limited use. More cases are needed to clarify this.
FAU - Kai, Shotaro
AU  - Kai S
AD  - Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, 
      Japan.
FAU - Fujita, Yasuyuki
AU  - Fujita Y
AD  - Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, 
      Japan.
FAU - Sato, Yuka
AU  - Sato Y
AD  - Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, 
      Japan.
FAU - Kido, Saki
AU  - Kido S
AD  - Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, 
      Japan.
FAU - Hidaka, Nobuhiro
AU  - Hidaka N
AD  - Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, 
      Japan.
FAU - Sakamoto, Ichiro
AU  - Sakamoto I
AD  - Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, 
      Japan.
FAU - Kato, Kiyoko
AU  - Kato K
AD  - Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, 
      Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20180919
PL  - England
TA  - J Matern Fetal Neonatal Med
JT  - The journal of maternal-fetal & neonatal medicine : the official journal of the 
      European Association of Perinatal Medicine, the Federation of Asia and Oceania 
      Perinatal Societies, the International Society of Perinatal Obstetricians
JID - 101136916
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Anticoagulants/*administration & dosage/therapeutic use
MH  - Aortic Valve/surgery
MH  - Drug Administration Schedule
MH  - Female
MH  - *Heart Valve Prosthesis Implantation
MH  - Heparin/*administration & dosage/therapeutic use
MH  - Humans
MH  - Postnatal Care/*methods
MH  - Postoperative Complications/*drug therapy
MH  - Pregnancy
MH  - Pregnancy Complications, Cardiovascular/*drug therapy
MH  - Prenatal Care/*methods
OTO - NOTNLM
OT  - Complications
OT  - pregnancy
OT  - unfractionated heparin
EDAT- 2018/09/21 06:00
MHDA- 2020/11/20 06:00
CRDT- 2018/09/21 06:00
PHST- 2018/09/21 06:00 [pubmed]
PHST- 2020/11/20 06:00 [medline]
PHST- 2018/09/21 06:00 [entrez]
AID - 10.1080/14767058.2018.1512573 [doi]
PST - ppublish
SO  - J Matern Fetal Neonatal Med. 2020 Mar;33(6):1030-1032. doi: 
      10.1080/14767058.2018.1512573. Epub 2018 Sep 19.