Pregnancy outcomes and cardiac complications in women with mechanical, bioprosthetic and homograft valves

• DOI: 10.1111/j.1471-0528.2000.tb11696.x
• Publication Date: 2005-08-12T10:44:09Z
• Authors: Lynn Sadler; Lesley McCowan; Harvey White; Alistair Stewart; Michael Bracken; Robyn North
• Keywords: Cardiac valve

Objectives Firstly, to compare pregnancy outcomes and cardiac complications in women with: 1. either mechanical or bioprosthetic valves at the mitral site; 2. treated with warfarin subcutaneous heparin. Secondly, determine aortic homograft valves. Design Historical cohort study. Setting Greenlane Hospital, Auckland, New Zealand. Population Young ( n = 255 ) who had valve replacements between 1972 1992. Seventy‐nine underwent 147 pregnancies. Main outcome measures Pregnancy loss, complications. Results loss occurred 59% of pregnancies 50 7% 33 (RR 8.20,95% CI2.10–31.93). rate was 70% warfarin, compared 25% for those switched from heparin 2.81, 95% CI 1.03–7.73). All heparin‐associated losses first trimester, whereas there were four stillbirths warfarin. Cardiac 10 (20%) (13%) 1.55, 0.53–4.52). thromboembolic 14 throughout pregnancy. Structural deterioration (10%) No known 41 ). Conclusion The high associated pregnancy, very good