Low molecular weight heparin treatment in pregnant women with a mechanical heart valve prosthesis.
No definitive recommendation is available concerning optimal antithrombotic therapy in pregnant women with a mechanical heart valve. The purpose of the current study was to evaluate the clinical results of nadroparin treatment with respect to pregnancy outcome and maternal complications. From 1997 to 2005, 31 pregnancies were reviewed in 25 women. Nadroparin (7,500 U, twice daily) was used in 23 pregnancies between 6 and 12 weeks of gestation and close-to-term only, and coumarin derivatives were used with aspirin at other times. Eight pregnant women treated with coumarin derivatives throughout pregnancy were compared to evaluate the safety and efficacy of nadroparin. No maternal death or bleeding complication occurred in either of the two groups, and frequencies of maternal thromboembolism including valve thrombosis (8.7% vs. 12.5%, p>0.05) were similar. However, the frequencies of live born (91.3% vs. 50%, p=0.01) and healthy babies (90.4% vs. 25%, p<0.01) were significantly higher, and the fetal loss rate was significantly lower (8.7% vs. 50%, p=0.01) in the nadroparin-treated group. Regarding the efficacy and safety of antithrombotic treatment in pregnant women with prosthetic heart valves, nadroparin treatment during the first trimester is an acceptable regimen and produces better results than coumarin derivatives.
Lee
Jae Hoon
JH
Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine, 194 Dongsan-dong, Joong-gu, Daegu, Korea.
Park
Nam Hee
NH
Keum
Dong Yoon
DY
Choi
Sae Young
SY
Kwon
Ki Young
KY
Cho
Chi Heum
CH
D000328:Adult; D003374:Coumarins / Q000008:administration & dosage; D005260:Female; D006349:Heart Valve Diseases / Q000209:etiology / Q000517:prevention & control*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D006849:Hydrocephalus / Q000139:chemically induced; D017762:Nadroparin / Q000008:administration & dosage* / Q000009:adverse effects*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology* / Q000517:prevention & control*; D011256:Pregnancy Outcome; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
D003374:Coumarins; D017762:Nadroparin; C030123:coumarin