心脏机械瓣膜置换术后妊娠期不同抗凝治疗策略比较

doi:10.20047/j.issn1673-7210.2023.18.11

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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.

Key words： Mechanical heart valves Pregnancy Anticoagulation strategy Warfarin Low molecular weight heparin Unfractionated heparin

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	KE Yijun1 WANG Wei2 WU Lifang3 JIN Yong3 QI Lamei1

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KE Yijun1 WANG Wei2 WU Lifang3 JIN Yong3 QI Lamei1. Comparison of different anticoagulant therapy strategies in pregnancy after mechanical heart valve replacement surgery[J]. 中国医药导报, 2023, 20(18): 51-55.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.18.11 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I18/51

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