COMPLICATIONS IN ANTICOAGULATION THERAPY FOR PREGNANT WOMEN WITH MECHANICAL HEART VALVE. CASE REPORT AND REVIEW OF THE LITERATURE
Aim: Bleeding complications happen more frequently in pregnant females who carry mechanical heart valves (MHVs) compared with biological prosthesis valves (BPVs). The main objective for these patients represents a rigorous and individual monitoring of the anticoagulant treatment in order to minimalize the rate of complications that may appear. We present from “Cuza-Vodă” Clinical Hospital of Obstetrics and Gynecology from Iasi, the case of a 30-year-old pregnant woman with dichorionic-diamniotic twin pregnancy, barrier of MHV, who suffered postoperative bleeding complication under guidelines recommended doses of anticoagulant. The hematoma that developed five days after the caesarian section need it surgical intervention for hemostasis correction. Conclusions: The incidence of bleeding complications is higher during pregnancy and postpartum in MHV carriers. Thrombosis or hemorrhage usually occur when the monitoring of anticoagulation is improper or when the treatment must be interrupted for different reasons.
2. Calin MA, Curteza A, Toma SL, Agop M. Morphological properties of polyamide 6-CNT nanofibers obtained by electrospinning method. Metalurgia International 2013; 18(1): 19-22.
3. Toma SL, Bejinariu C, Gheorghiu DA, Baciu C. The improvement of the physical and mechanical properties of steel deposits obtained by thermal spraying in electric arc. Advanced Materials Research 2013; 814: 173-179.
4. Irimciuc SA, Agop M, Nica P, et al. Dispersive effects in laser ablation plasmas. Jpn J Appl Phys 2014; 53(11): 116202.
5. Sillesen M, Hjortdal V, Vejlstrup N, Sorensen K. Pregnancy with prosthetic heart valves-30 years’ nationwide experience in Denmark. Eur J Cardiothorac Surg 2011; 40(2): 448-454.
6. Chan WS, Anand S, Ginsberg JS. Anticoagulation of pregnant women with mechanical heart valves: A systematic review of the literature. Arch Intern Med 2000; 160(2): 191-196.
7. Iturbe-Alessio I, Fonseca MC, Mutchinik O, Santos MA, Zajarias A, Salazar E. Risks of anticoagulant therapy in pregnant women with artificial heart valves. N Engl J Med 1986; 315(22): 1390-1393.
8. Hassouna A, Allam H. Limited dose warfarin throughout pregnancy in patients with mechanical heart valve prosthesis: a meta-analysis. Interact Cardiovasc Thorac Surg 2014; 18(6): 797-806.
9. Regitz-Zagrosek V, Lundqvist CB, Borghi C, et al. ESC Guidelines on the management of cardiovas-cular diseases during pregnancy: the task force on the management of cardiovascular diseases during pregnancy of the European Society of Cardiology (ESC). Eur Heart J 2011; 32(24): 3147-3197.
10. Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2017; 70(2): 252-289.
11. Steinberg ZL, Dominguez-Islas CP, Otto CM, Stout KK, Krieger EV. Maternal and fetal outcomes of anticoagulation in pregnant women with mechanical heart valves. J Am Coll Cardiol 2017; 69(22): 2681-2691.
12. D`Souza R, Ostro J, Shah PS, et al. Anticoagulation for pregnant women with mechanical heart valves: a systematic review and meta-analysis. Eur Heart J 2017; 38(19): 1509-1516.
13. van Hagen IM, Roos-Hesselink JW, Ruys TPE, et al. Pregnancy in women with mechanical heart valve: Data of the European Society of Cardiology Registry of pregnancy and cardiac disease (ROPAC). Circulation 2015; 132(2): 132-142.
14. Vause S, Clarke B, Tower CL, Hay C. Knight M. Pregnancy outcomes in women with mechanical prosthetic heart valves: A prospective descriptive population-based study using the United Kingdom Obstetric Surveillance System (UKOSS) Data collection system. BJOG 2017; 124(9): 1411-1419.
15. Rodriguez MB, Lethaby A, Grigore M, Brown J, Hickey M, Farquhar C. Endometrial resection and ablation techniques for heavy menstrual bleeding (Review). Cochrane Database Syst Rev 2019; 1(1): CD001501.
16. Anton E, Rotaru A, Covatariu D, et al. Links between extremely high frequency electromagnetic waves and their biological manifestations Archives of Biological Sciences Belgr 2015; 67(3): 895-897.
17. Aursulesei V, Vasincu D, Timofte D, et al. New mechanisms of vesicles migration. Gen Physiol Biophys 2016; 35(3): 287-298.
18. Trofin F, Ciobica A, Honceriu C, et al. Modulatory effects of vitamin C on the relation between physical exercising and oxidative stress at young smokers, Romanian Biotechnological Letters 2017; 22(2): 12439- 12447.
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
N.B. All the authors must sign this form