State of the Art Management of Mechanical Heart Valves During Pregnancy.
Review published in Current treatment options in cardiovascular medicine (2018)
Abstract
PURPOSE OF THE REVIEW: To review the management of women with mechanical heart valves during pregnancy, from preconception counseling through delivery with a summary of the latest guidelines. RECENT FINDINGS: The hypercoagulability of pregnancy combined with the imperfect choices of anticoagulant agents contribute to a high risk of complications in pregnant women with mechanical heart valves. Valve thrombosis remains a major concern, much of which occurs during the first trimester transition to heparin-based products. The safest method of anticoagulation, with the best balance of maternal and fetal risk, is use of low-dose vitamin K antagonists, but only if therapeutic anticoagulation can be achieved with warfarin doses of ≤ 5 mg/day. Management of mechanical heart valves in pregnancy remains fraught with difficult decisions involving balancing of maternal and fetal risks as well as a high risk of maternal and fetal complications. Preconception counseling and planning is imperative. A risk-benefit discussion with the patient will help guide the choice of anticoagulation and outline the plan for safe delivery options. A multidisciplinary approach to management is advisable with close follow-up and care in a tertiary center.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
To review the management of women with mechanical heart valves during pregnancy, from preconception counseling through delivery with a summary of the latest guidelines. The hypercoagulability of pregnancy combined with the imperfect choices of anticoagulant agents contribute to a high risk of...
Por qué esto importa para la hirudoterapia
Este artículo de revisión examinó las estrategias de manejo de última generación para mujeres embarazadas con válvulas cardíacas mecánicas, enfocándose en el delicado equilibrio de los riesgos maternos y fetales asociados con terapias anticoagulantes como la heparina y los antagonistas de la vitamina K. Para la Sociedad Americana de Hirudoterapia, este texto destaca los desafíos clínicos extremos de la trombosis sistémica y la hipercoagulabilidad durante el embarazo. Si bien la hirudoterapia no está indicada sistémicamente para válvulas cardíacas mecánicas, comprender las complicaciones de los anticoagulantes sistémicos contextualiza la naturaleza localizada de los anticoagulantes derivados de sanguijuela como la hirudina. Sin embargo, el alcance del estudio está estrictamente limitado al manejo farmacológico convencional, y no hay mención de sanguijuelas, hirudoterapia ni del secretoma de la sanguijuela en el resumen.
Citación
State of the Art Management of Mechanical Heart Valves During Pregnancy.
Aggarwal et al. · Current treatment options in cardiovascular medicine, 2018
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026