Risks and Pregnancy Outcome in Women With Prosthetic Mechanical Heart Valve Replacement
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概要
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Background Pregnancy after mechanical heart valve replacement is highly risky for both mother and child because of the aggravation of maternal heart function and adverse effects of anticoagulation therapy. In Japan, however, the risks and pregnancy outcomes in women with prosthetic mechanical heart valve replacement remain to be elucidated. Methods and Results In the present study 16 pregnancies in 12 women with prosthetic mechanical heart valve replacement were identified between 1983 and 2005. At 6-13 weeks of gestational age, warfarin, an anticoagulant agent, was changed to heparin and administration was continuously adjusted according to the activated partial thromboplastin time level up to the time of delivery. Major maternal complications and pregnancy outcomes were retrospectively investigated. The valve replaced was mitral (n=7), tricuspid (n=7), and aortic (n=2). Eight (50%) of 16 had cesarean live births. One case was delivered at full term, and 7 cases were delivered preterm (26-36 weeks) because of maternal indications. Two babies died in the neonatal period. Therapeutic abortion was performed in 3 cases, 4 cases ended in early miscarriage, and 1 case ended in intrauterine fetal death (30 weeks). Three mothers developed valve (mitral, tricuspid, aortic) thrombosis. There was 1 maternal death from heart failure. Conclusions Pregnancy after mechanical heart valve replacement requires strict control of coagulation. Special attention should be paid to the occurrence of complications during anticoagulation therapy.
- 社団法人日本循環器学会の論文
- 2007-01-20
著者
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Endo Shiho
Department Of Perinatology National Cardiovascular Center
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Ikeda Tomoaki
Department of Perinatology, National Cardiovascular Center
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Neki Reiko
Department of Perinatology, National Cardiovascular Center
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Kawasoe Yasutaka
Department Of Adult Congenital Heart Disease And Pediatric Cardiology Chiba Cardiovascular Center
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Ikeda Tomoaki
Department Of Perinatology National Cardiovascular Center
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Ikeda Tomoaki
Department Of Obsterics And Gyneclogy Miyazaki Medical College University Of Miyazaki
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DOUCHI Tsutomu
Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University
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Fukuda Hirotugu
Department of Cardiothoracic Surgery, Dokkyo Univ. School of Medicine
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Kawamata Kazuya
Department of Perinatology, National Cardiovascular Center
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Yamanaka Kaoru
Department of Perinatology, National Cardiovascular Center
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Neki Reiko
Department Of Perinatology National Cardiovascular Center
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Yamanaka Kaoru
Department Of Perinatology National Cardiovascular Center
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Yamanaka Kaoru
Department Of Electronic Engineering Institute Of Vocational Training
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Douchi Tsutomu
Department Of Obstetrics And Ginecology Kagoshima University Graduate School Of Medical And Dental S
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Fukuda Hirotugu
Department Of Cardiothoracic Surgery Dokkyo Univ. School Of Medicine
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Fukuda Hirotugu
Department Of Perinatology National Cardiovascular Center
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Kawamata Kazuya
Department Of Perinatology National Cardiovascular Center:department Of Obstetrics And Gynecology Fa
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Neki Reiko
Department Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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IKEDA Tomoaki
National Cerebral and Cardiovascular Center
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Neki Reiko
Departments Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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Kawamata Kazuya
Department Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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IKEDA Tomoaki
Deparartment of Perinatology, National Cardiovascular Center
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