Biological versus mechanical heart valve prosthesis during pregnancy in women with congenital heart disease

International Journal of Cardiology
Heleen LameijerPetronella G Pieper

Abstract

We evaluate pregnancy outcome and anticoagulation regimes in women with mechanical and biological prosthetic heart valves (PHV) for congenital heart disease. Retrospective multicenter cohort studying pregnancy outcomes in an existing cohort of patients with PHV. 52 women had 102 pregnancies of which 78 pregnancies (46 women) ≥20 weeks duration (59 biological, 19 mechanical PHV). Miscarriages (n = 19, ≤20 weeks) occurred more frequently in women using anticoagulation (P < .05). During 42% of pregnancies of women with mechanical PHV a combined low molecular weight heparin (LMWH) vitamin-K-antagonist anticoagulation regime was used (n = 8). Overall, cardiovascular, obstetric and fetal/neonatal complications occurred in 17% (n = 13), 68% (n = 42) and 42% (n = 27) of the pregnancies. Women with mechanical PHV had significantly higher cardiovascular (12% vs 32%, P < .05), obstetric (59% vs 85%, P = .02) and fetal/neonatal (34% vs 61%, P < .05) complication rates than women with biological PHV. This was related to PHV thrombosis (n = 3, P < .02), post-partum hemorrhage (P < .02), cesarean section (P < .02), low birth weight and small for gestational age (both P < .05). PHV thrombosis occurred in 3 pregnancies, including 2/5 pregnancie...Continue Reading

Citations

Mar 21, 2019·Current Opinion in Anaesthesiology·Eitan MangoubiSharon Orbach-Zinger
May 5, 2020·Circulation·Laxmi S MehtaUNKNOWN American Heart Association Council on Clinical Cardiology; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Cou
Dec 22, 2020·American Journal of Obstetrics & Gynecology MFM·Samuel C SiuJoel G Ray

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