title: Influence of heart-valve replacement of warfarin anticoagulant therapy on perinatal outcomes.
abstract: OBJECTIVE
  To explore the influence of the single use of perinatal warfarin anticoagulation therapy on pregnancy outcome after the mechanical heart-valve replacement surgery in pregnant women.
  
  
  METHODS
  Fifty-eight cases of pregnant women after heart-valve replacement surgery (2005.1-2009.12) received low-dose warfarin anticoagulation therapy. The perinatal outcomes included: (1) maternal complications: thrombosis, hemorrhage, heart failure, etc., and (2) adverse perinatal outcomes: miscarriage, stillbirth, neonatal death, fetal malformation, preterm delivery, such as warfarin syndrome.
  
  
  RESULTS
  In 58 patients, valve thrombosis was found in one case of pregnancy, general hemorrhage was found in 16 cases, spontaneous abortion was found in two cases, malformation was found in two cases. There were no stillbirth and neonatal death. Three cases were premature delivery. Thirty-two of 56 cases were late pregnancy vaginal delivery. Twenty-four cases were cesarean section produced, in which heart failure happened in 1 case and late postpartum hemorrhage happened in one case.
  
  
  CONCLUSIONS
  The low-dose and low-intensity warfarin anticoagulation therapy during pregnancy is good for patients with good compliance and low rate of fetal malformations and can effectively prevent maternal complications.
authors.affiliation: Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China.
authors.forename: Ce
authors.initials: C
authors.lastname: Bian
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.forename: Xinghui
authors.initials: X
authors.lastname: Liu
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001021:Aortic Valve; D058385:Cardiac Valve Annuloplasty / Q000009:adverse effects*; D002585:Cesarean Section; D000013:Congenital Abnormalities / Q000209:etiology; D036861:Delivery, Obstetric; D004438:Ecchymosis / Q000209:etiology; D004844:Epistaxis / Q000209:etiology; D005260:Female; D005884:Gingival Hemorrhage / Q000209:etiology; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology; D013927:Thrombosis / Q000209:etiology; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014859:Warfarin