title: Pregnancy in women with prosthetic heart valves.
abstract: Pregnancy in women with mechanical valve prostheses has a high maternal complication rate including valve thrombosis and death. Coumarin derivatives are relatively safe for the mother with a lower incidence of valve thrombosis than un-fractionated and low-molecular-weight heparin, but carry the risk of embryopathy, which is probably dose-dependent. The different anticoagulation regimens are discussed in this review. When valve thrombosis occurs during pregnancy, thrombolysis is the preferable therapeutic option. Bioprostheses have a more favourable pregnancy outcome than mechanical prostheses but due to the high re-operation rate in young women they do not constitute the ideal alternative. When women with native valve stenosis need pre-pregnancy intervention, mitral balloon valvuloplasty is the best option in mitral stenosis, while the Ross operation or homograft implantation may be the preferable surgical regimen in aortic stenosis. (Neth Heart J 2008;16:406-11.).
authors.affiliation: Thorax Centre, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: P G
authors.initials: PG
authors.lastname: Pieper
authors.forename: A
authors.initials: A
authors.lastname: Balci
authors.forename: A P
authors.initials: AP
authors.lastname: Van Dijk