Is Oral Anticoagulant with High dose in Pregnant Women with Prosthetic Mechanical Valve Effective and Safe?
Eltahlawi, M., Alanwar, M., Elnahal, N., Abdelsayed, A., Tharwat, M. (2020). Is Oral Anticoagulant with High dose in Pregnant Women with Prosthetic Mechanical Valve Effective and Safe?. EKB Journal Management System, 26(3), 450-454. doi: 10.21608/zumj.2020.23331.1717
Mohammad Eltahlawi; Mohammad Alanwar; Nezar Elnahal; Amir Abdelsayed; Marwa Tharwat. "Is Oral Anticoagulant with High dose in Pregnant Women with Prosthetic Mechanical Valve Effective and Safe?". EKB Journal Management System, 26, 3, 2020, 450-454. doi: 10.21608/zumj.2020.23331.1717
Eltahlawi, M., Alanwar, M., Elnahal, N., Abdelsayed, A., Tharwat, M. (2020). 'Is Oral Anticoagulant with High dose in Pregnant Women with Prosthetic Mechanical Valve Effective and Safe?', EKB Journal Management System, 26(3), pp. 450-454. doi: 10.21608/zumj.2020.23331.1717
Eltahlawi, M., Alanwar, M., Elnahal, N., Abdelsayed, A., Tharwat, M. Is Oral Anticoagulant with High dose in Pregnant Women with Prosthetic Mechanical Valve Effective and Safe?. EKB Journal Management System, 2020; 26(3): 450-454. doi: 10.21608/zumj.2020.23331.1717

Is Oral Anticoagulant with High dose in Pregnant Women with Prosthetic Mechanical Valve Effective and Safe?

Zagazig University Medical Journal
Article 11, Volume 26, Issue 3, May 2020, Page 450-454  XML PDF (592.9 K)
Document Type: Original Article
DOI: 10.21608/zumj.2020.23331.1717
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Authors
Mohammad Eltahlawi email 1; Mohammad Alanwar2; Nezar Elnahal3; Amir Abdelsayed3; Marwa Tharwatorcid 4
1Cardiology Department, Faculty of Medicine, Zagazig University
2Department of Cardiothoracic surgery, Faculty of Medicine, Zagazig University
3Cardiothoracic Surgery, Faculty of Medicine, Zagazig University
4Department of Anatomy & Emberyology, Faculty of Medicine, Zagazig University
Abstract
Background: The management of women with prothetic valves in pregnancy remains challenging. Anticoagulation in these subgroups has many controversies.
Aim: We aim to evaluate the safety dose of oral anticoagulant in pregnant women with mechanical valve prosthesis in first trimester.
Patients &Methods: Pregnant ladies with well functioning prothetic valves were enrolled. Patients were divided into 3 groups: Group A took oral anticoagulant < 5 mg warfarin with therapeutic INR. Group B took low molecular weight heparin (LMWH) twice daily and monitoring is done every week by antifactorXa 4-6 hours post-injection to keep about 1 IU/ml. Group C took oral anticoagulant in dose > 5 mg warfarin to reach therapeutic INR.
Results: There was significant difference between groups in vaginal bleeding and abortion, with more bleeding and abortion in group Busing LMWH. There was a high rate of malfunction valve about 19.9% in group B, but no reportedcases of malfunction valve in the other both groups using warfarin.
Conclusion: Warfarin with dose > 5 mg in pregnant women with mechanical prosthetic valve is as safe for mother and baby as warfarin with dose < 5 mg. Both regimens are safer than LMWH.
Keywords
Oral anticoagulant; Warfarin; Pregnancy; Prothetic valve; Teratogenic
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