The risk of fetal loss associated with Warfarin anticoagulation.
OBJECTIVE
To examine if fetal risks associated with Warfarin anticoagulation during pregnancy may have been over-estimated at the time the drug was contraindicated during pregnancy.


METHODS
Seven case series with the same therapeutic objective for Warfarin anticoagulation published after 1980 were identified. The frequencies of fetal complications were calculated and compared with those of the 1980 compilation.


RESULTS
The frequencies of embryopathy, stillbirths, and neonatal deaths were similar to the 1980 database, but higher with respect to spontaneous abortions (24.1 vs. 8.6%) and premature deliveries (13.9 vs. 4.6%), and lower regarding live births (73.3 vs. 83.7%).


CONCLUSIONS
Fetal risks associated with Warfarin anticoagulation during pregnancy have not been overestimated. Warfarin should not be given in cases where other anticoagulants do not increase the risk for the expecting mother.
Blickstein
D
D
Institute of Hematology, Rabin Medical Center, Petach-Tikva, Israel.
Blickstein
I
I
D000022:Abortion, Spontaneous / Q000139:chemically induced; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D000075202:Contraindications; D005260:Female; D005313:Fetal Death / Q000139:chemically induced*; D005315:Fetal Diseases / Q000139:chemically induced; D006349:Heart Valve Diseases / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D018811:Maternal Exposure / Q000009:adverse effects*; D007752:Obstetric Labor, Premature / Q000139:chemically induced; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin