Pregnancy in patients with prosthetic heart valves: An experience with 45 pregnancies

Abstract

Between 1974 and 1981, 27 patients became pregnant after prosthetic heart valve replacement with a total of 45 pregnancies. Four pregnancies terminated in therapeutic abortions. Of the remaining 41 pregnancies, 30 were associated with the use of anticoagulants and 11 not. Haemorrhage related to anticoagulant therapy occurred in one patient. The foetal loss in the group with anticoagulant therapy was 33% (10 abortions) and that in the group without was 9% (1 abortion). The use of aspirin and dipyridamole during pregnancy (8 pregnancies) did not appear to threaten the outcome of pregnancy. A total of 30 babies were born alive and 20% of them were light for date. There was no perinatal mortality. The typical warfarin embryopathy was not found. Congenital anomalies in 4 newborns included congenital hydrocephalus, harelip and complete cleft palate, bilateral accessory auricles and bilateral incurving 5th fingers. Subsequently, all except the newborn with congenital hydrocephalus showed normal developmental milestones.