AI Article Synopsis
- Pregnancy with mechanical heart valves poses a high risk of valve thrombosis due to increased blood clotting, and the use of warfarin is limited because it can harm the fetus.
- Managing a pregnant woman with mitral and aortic mechanical heart valves and placenta previa is challenging, as it can lead to severe postpartum bleeding.
- The case discussed highlights successful management using careful heparin dosage and monitoring, along with compression sutures to control bleeding from the placenta previa.
Article Abstract
Pregnancy with a mechanical heart valve (MHV) is high risk for valve thrombosis because pregnancy is a hyper-coagulation state. In addition, warfarin use during pregnancy is restricted due to its fetotoxicity, and postpartum bleeding may be increased with anticoagulation. In particular, placenta previa under anticoagulation may cause massive postpartum bleeding. The optimal anticoagulation for a pregnant woman with mitral and aortic double MHVs is not known. In addition, suitable techniques for control of bleeding in a case of placenta previa under anticoagulation are not known. Thus, a case of a pregnant woman with mitral and aortic double MHVs and placenta previa is presented. The case was managed without valve thrombosis through precise unfractionated heparin dose adjustment and frequent activated partial thromboplastin time monitoring, along with maintenance of antithrombin levels. Compression sutures were found to be effective for controlling bleeding from the attachment site of placenta previa even under anticoagulation.
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| http://dx.doi.org/10.1007/s11748-020-01494-0 | DOI Listing |
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