Comparison of different anticoagulant therapy strategies in pregnancy after mechanical heart valve replacement surgery
KE Yijun1 WANG Wei2 WU Lifang3 JIN Yong3 QI Lamei1
1.Department of Pharmacy Administration, Anqing Medical Center, Anhui Medical University, Anhui Province, Anqing 246000, China;
2.Department of Gastroenterology, Anqing Medical Center, Anhui Medical University, Anhui Province, Anqing 246000, China;
3.School of Pharmacy, Anhui Medical University, Anhui Province, Hefei 230000, China
Abstract：The hypercoagulable state during pregnancy increases the risk of thromboembolism in pregnant women after mechanical heart valve replacement surgery, and effective anticoagulant therapy is very important. Warfarin can effectively prevent valve thrombosis, which is the safest for the mother, but can cause embryopathy. Unfractionated heparin and low molecular weight heparin are safe for the fetus, but have weak antithrombotic effects and increase the risk of maternal valve thrombosis. At present, there are few studies on the use of new oral anticoagulants in patients after mechanical heart valve replacement surgery, and the existing evidence is not recommended for such populations. With the deepening of research, for patients with high embolism risk who can reach the target international normalized ratio by using low dose Ｗarfarin (less than or equal to 5 mg/d), Ｗarfarin may be considered throughout pregnancy. If high dose Ｗarfarin (greater than 5 mg/d) is used to achieve the target international normalized ratio, low molecular weight heparin with adjusted dosage can be used in the early pregnancy, and Ｗarfarin can be used in the middle and late pregnancy.
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