title: Recommendations for the anticoagulation of pregnant patients with mechanical heart valves.
abstract: BACKGROUND
  The management of pregnant patients with mechanical heart valves remains challenging because there are no large randomised studies to provide guidelines for effective anticoagulant therapy. Both vitamin K antagonists and heparins may be associated with maternal and foetal adverse events.
  
  
  METHODS
  The Southern African Society of Thrombosis and Haemostasis reviewed available literature and comprehensive evidence-based guidelines for the anticoagulation of pregnant patients with mechanical heart valves. A draft document was produced and revised by consensus agreement. The guidelines were adjudicated by independent international experts to avoid local bias.
  
  
  CONCLUSIONS
  We present concise, practical guidelines for the clinical management of pregnant patients with mechanical heart valves. Recommendations reflect current best practice which will hopefully lead to improved anticoagulation practice in this select group of high risk patients.
authors.affiliation: Charlotte Maxeke Johannesburg Academic Hospital, South Africa; Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa. elise.schapkaitz@nhls.ac.za.
authors.forename: Elise
authors.initials: E
authors.lastname: Schapkaitz
authors.forename: Barry Frank
authors.initials: BF
authors.lastname: Jacobson
authors.forename: Pravin
authors.initials: P
authors.lastname: Manga
authors.forename: Rufaro Saeed
authors.initials: RS
authors.lastname: Chitsike
authors.forename: Estee
authors.initials: E
authors.lastname: Benade
authors.forename: S
authors.initials: S
authors.lastname: Jackson
authors.forename: Sylvia
authors.initials: S
authors.lastname: Haas
authors.forename: Harry R
authors.initials: HR
authors.lastname: Buller