Prosthetic heart valve in pregnancy

Fatemeh massomeh Akbarzadeh,1,* Fatemeh kazemi navaei,2 Kolsoom salehi,3

1. Azad University of Babol
2. Azad University of Babol
3. Azad University of Babol

Abstract

Introduction

Women in pregnancy age may use mechanical or biological valves due to congenital and acquired diseases of heart valves. this study compares the complications and implications of prosthetic heart valves in pregnancy.

Methods

This review paper was extracted after searching in pubmed, scopus, sid, medline, and google scholar databases with keywords of prosthetic heart valve, pregnancy, side effects, and implication. 15 new articles with more relevance with the subject studied were selected of the 29 related articles that were reviewed and used in writing the article.

Results

Arrhythmia, heart failure, bleeding, thromboembolism, endocarditis, and death are the side effects of many types of artificial valves in pregnancy. mechanical valves have more durability compared to biological valves, they tolerate hemodynamic changes very well, and the probability of their failure in pregnancy is low. but they need anticoagulant drugs due to the high risk of thromboembolism. unlike heparin, the use of warfarin increases the abortion, preterm labor, stillbirth, warfarin embryopathy and fetal bleeding, but the risk of thromboembolism in mother is greatly reduced.

Conclusion

Pregnant women with a various artificial valves require special cares. given the side effects of warfarin, most studies have recommended the use of heparin during pregnancy period. warfarin has no contraindication during breastfeeding.

Keywords

Prosthetic heart valve, pregnancy, complications, implication.