[Anticoagulant treatment and pregnancy. Apropos of 47 cases].
The authors report a series of 47 patients treated with anticoagulants during pregnancy. The commonest indication was the presence of an artificial heart valve (72.3% of cases), most often mitral (58.9%). Thirty seven women were treated with heparin (group I) and ten with oral anticoagulants (OA) (group II) during the first three months. There was one peripheral venous thrombotic event and 2 post-partum deaths. Obstetric complications were equally distributed between the 2 groups, with the exception of spontaneous abortions during the first three months and fetal deaths, which were commoner with OA. Hemorrhagic complications occurred in 17% of cases at the time of delivery and during the immediate post-partum period. One case of coumarin embryopathy was seen. This series confirms that three periods are dangerous in the context of anticoagulant treatment during pregnancy: the first three months, delivery and postpartum. We recommend the use of heparin during the first three months and at the end of pregnancy, restricting OA to the period between 4 and 9 months.
Lecuru
F
F
Service de Gynécologie-Obstétrique, Hôpital Boucicaut, Paris.
Taurelle
R
R
Desnos
M
M
D015110:4-Hydroxycoumarins; D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy; D005260:Female; D006333:Heart Failure / Q000188:drug therapy; D006350:Heart Valve Prosthesis; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007192:Indenes; D011247:Pregnancy; D011248:Pregnancy Complications; D013924:Thrombophlebitis / Q000188:drug therapy; D014812:Vitamin K / Q000009:adverse effects / Q000037:antagonists & inhibitors / Q000627:therapeutic use
D015110:4-Hydroxycoumarins; D000925:Anticoagulants; D007192:Indenes; C011664:antivitamins K; D014812:Vitamin K; D006493:Heparin
Traitement anticoagulant et grossesse. A propos de 47 observations.