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Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study
Objective: To document maternal and foetal morbidity and mortality in anticoagulated, pregnant patients with mechanical heart valves until 42 days postpartum. Methods: In a tertiary single-centre, prospective cohort, 178 consecutive patients at the cardiac-obstetric clinic were screened for warfarin...
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| Format: | Thesis |
| Language: | English |
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Department of Medicine
2020
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| _version_ | 1867613198657519616 |
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| access_status_str | Open Access |
| author | Kariv, Sarah |
| author2 | Sliwa, Karen |
| author_browse | Kariv, Sarah Sliwa, Karen |
| author_facet | Sliwa, Karen Kariv, Sarah |
| author_sort | Kariv, Sarah |
| collection | Thesis |
| description | Objective: To document maternal and foetal morbidity and mortality in anticoagulated, pregnant patients with mechanical heart valves until 42 days postpartum. Methods: In a tertiary single-centre, prospective cohort, 178 consecutive patients at the cardiac-obstetric clinic were screened for warfarin use between 1 July 2010 and 31 December 2015. Of 33 pregnancies identified, 29 were included. Patients received intravenous unfractionated heparin from six to 12 weeks’ gestation and peripartum, and warfarin from 12 to 36 weeks. Maternal outcomes including death, major haemorrhage and thrombosis, and foetal outcomes were documented. Results: There were two maternal deaths, five returns to theatre post-delivery, eight patients transfused, six major haemorrhages, one case of infective endocarditis and three ischaemic strokes. Ten pregnancies had poor foetal outcomes (six miscarriages, three terminations, one early neonatal death). Twenty patients required more than 30 days’ hospitalisation, and 15 required three or more admissions. HIV positivity was associated with surgical delivery (p = 0.0017). Conclusions: Complication rates were high despite centralized care. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/31685 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:20.328Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/31685 Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study Kariv, Sarah Sliwa, Karen warfarin heparin, pregnancy anticoagulation mechanical heart valves Africa Objective: To document maternal and foetal morbidity and mortality in anticoagulated, pregnant patients with mechanical heart valves until 42 days postpartum. Methods: In a tertiary single-centre, prospective cohort, 178 consecutive patients at the cardiac-obstetric clinic were screened for warfarin use between 1 July 2010 and 31 December 2015. Of 33 pregnancies identified, 29 were included. Patients received intravenous unfractionated heparin from six to 12 weeks’ gestation and peripartum, and warfarin from 12 to 36 weeks. Maternal outcomes including death, major haemorrhage and thrombosis, and foetal outcomes were documented. Results: There were two maternal deaths, five returns to theatre post-delivery, eight patients transfused, six major haemorrhages, one case of infective endocarditis and three ischaemic strokes. Ten pregnancies had poor foetal outcomes (six miscarriages, three terminations, one early neonatal death). Twenty patients required more than 30 days’ hospitalisation, and 15 required three or more admissions. HIV positivity was associated with surgical delivery (p = 0.0017). Conclusions: Complication rates were high despite centralized care. 2020-04-23T14:45:30Z 2020-04-23T14:45:30Z 2019 2020-04-23T01:19:17Z Master Thesis Masters MMed https://hdl.handle.net/11427/31685 eng application/pdf Department of Medicine Faculty of Health Sciences |
| spellingShingle | warfarin heparin, pregnancy anticoagulation mechanical heart valves Africa Kariv, Sarah Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study |
| thesis_degree_str | Master's |
| title | Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study |
| title_full | Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study |
| title_fullStr | Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study |
| title_full_unstemmed | Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study |
| title_short | Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study |
| title_sort | haemorrhage and other complications in pregnant women on anticoagulation for mechanical heart valves a prospective observational cohort study |
| topic | warfarin heparin, pregnancy anticoagulation mechanical heart valves Africa |
| url | https://hdl.handle.net/11427/31685 |
| work_keys_str_mv | AT karivsarah haemorrhageandothercomplicationsinpregnantwomenonanticoagulationformechanicalheartvalvesaprospectiveobservationalcohortstudy |