Note:
11 Mitral tilting disc prostheses at particular risk: fatal thrombotic
occlusion of these valves in pregnant women described despite
well-controlled heparin anticoagulation
22 Risk of significant warfarin embryopathy not as high as
previously thought, especially if the mother achieves adequate
anticoagulation on <5mg warfarin.
33 No data on low molecular weight heparin in this situation, so
its use cannot be recommended.
TThhee ppaattiieenntt mmuusstt bbee ffuullllyy iinnffoorrmmeedd,, aanndd iinnvvoollvveedd iinn ddeecciiddiinngg
hheerr mmooddee ooff aannttiiccooaagguullaattiioonn ((mmeeddiiccoolleeggaall iimmpplliiccaattiioonnss))..
FFuurrtthheerr rreeaaddiinngg
Salazar E, Izaguirre R, Verdejo J et al. Failure of adjusted doses of sub-
cutaneous doses of heparin to prevent thromboembolic phenomena in
pregnant patients with mechanical cardiac valve prostheses. J Am Coll
Cardiol 1996; 2277 : 1698–703.