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Combined use of warfarin and adjusted subcutaneous heparin during pregnancy in patients with an artificial heart valve.

Abstract：

:Adjusted subcutaneous heparin was used for thromboembolism prophylaxis during 18 pregnancies in 16 women with an artificial heart valve. Oral warfarin was replaced by subcutaneous heparin as soon as pregnancy was confirmed. The dosage of heparin was adjusted to maintain a partial thromboplastin time at 1.5 times the control value and treatment was administered during the first trimester and the last 3 weeks of gestation. Warfarin was used between the 13th and 37th week. There were no maternal thromboembolic complications and none of the live-born infants showed congenital malformations, indicating that this regimen is effective. However, there were nine spontaneous abortions, including five that occurred in the first 12 weeks. The early abortions were probably related to warfarin exposure at the beginning of pregnancy. The preconception replacement of warfarin by heparin in these patients may be indicated.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Lee PK,Wang RY,Chow JS,Cheung KL,Wong VC,Chan TK

doi

10.1016/s0735-1097(86)80116-4

subject

Has Abstract

pub_date

1986-07-01 00:00:00

pages

221-4

issue

1

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(86)80116-4

journal_volume

8

pub_type

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