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Abstract

Background:Patients with mechanical heart valves have an elevated risk of maternal morbidity and mortality after delivery. This work aimed to compare the occurrence of postpartum bleeding complication in relation to warfarin dose after cesarean delivery in cases with mechanical heart valve prosthesis. Methods: This cross-sectional research involved 57 high risk pregnancy outpatient clinics of 20-40 years old and had mechanical prosthetic mitral and/or aortic valves. All patients underwent thorough history taking, general examination, preoperative routine laboratory investigations (coagulation profile, liver & kidney functions, complete blood count, and fasting & 2h postprandial blood glucose levels) and antenatal ultrasonography.Results: 1ry postpartum haemorrhage was found in one patient, intraperitoneal haemorrhage was found in two patients, SC hematoma was found in 3 patients, and SR hematoma was found in 3 patients. While no cases of valve thrombosis or other thromboembolic events were reported. SC hematoma started with mean of 14.45 cm 2 and reached 8.43 cm 2 on day 14. While SR hematoma started with mean of 33.04 cm 2 and reached 11.81 cm 2 on day 14. Mean of biggest hematoma size recorded was 6.1 cm and ranged from 3 -10. Conclusions: Women with prosthetic heart valves who are of childbearing age should be counselled about potential pregnancy complications. The incidence of 1ry postpartum hemorrhage in individuals receiving Warfarin is roughly 1.8%; according to the existing data, Warfarin is the optimal choice for patients with prosthetic heart valves during pregnancy.