[Pregnancy and delivery following cardiac valve replacement (author's transl)].

Abstract

We describe 30 patients with Starr-Edwards cardiac valve replacements who underwent pregnancy. Fourteen pregnant women who received anticoagulants gave rise to 3 neonatal anomalies such as congenital heart disease, polydactylia and microphthalmus. And fetal losses were 5 spontaneous abortions. Women with artificial valves can tolerate the hemodynamic load of pregnancy well, but there is an increased fetal wastage in patients taking oral anticoagulants (coumarin: warfarin). Namely, there is probably largely attributable to fetal hemorrhage but there is also a risk of malformation caused by teratogenic effects of warfarin. In contrast, pregnant women who didn't receive anticoagulants had the risk of thrombo-embolismus. It is suggested that the best plan is to use long acting oral anticoagulants during antenatal period and heparin over the periods of labor.