الفهرس 
The choices of anticoagulants and their effects in pregnant women with metallic prosthetic heart valves
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Abstract
Background: The management of a pregnant woman who has a metallic prosthetic heart valve represents a real challenge for the medical staff. Patients with mechanical valve prostheses are at high risk for thromboembolic events and mortality increases during pregnancy. Objectives: This study attempted to find the fetal and maternal outcome in pregnant women with prosthetic heart valve and comparing between the three regimens of anticoagulants throughout pregnancy either (heparin-warfarin-heparin), (warfarin) or (heparin) and the best choice between them. Patients and Methods: This is a case series prospective study done from (January 2013 to December 2015) and including 119 pregnancies of (112 women) with one or more mechanical prosthetic heart valve patients were divided according to their choices of anticoagulant regimen after proper counseling into three groups: group one (n=71) were on (heparin-warfarin-heparin), group two (n=28) were on warfarin and group three (n=20) were on heparin throughout the pregnancy. Results: Maternal outcomes in 119 pregnancies were as following; no complications in (78/119) (65.5%), maternal complications occurred in (34.5%) (41/119) and pregnancy outcomes were as following, (57/119) (47.9%) resulted in full term babies. The total live births were higher with (heparin-warfarin-heparin) (59/71) (83%), fetal complications occurred in 62/119 cases 52.1%