Near fatal puerperal thrombosis on Bjork-Shiley mitral valve prosthesis.

Abstract

A 22-year-old woman required emergency mitral valve replacement three weeks post partum because of thrombotic obstruction of her prosthetic mitral valve. Low dose subcutaneous heparin was administered from the 17th week of pregnancy. Though there was a successful fetal outcome, heparin did not prevent thrombosis on the prosthesis and its continuation into the puerperium proved nearly fatal.

Long‐term ambulatory anticoagulation by constant subcutaneous heparin infusion in pregnancy.

“…The drug is cumbersome to administer and to control, and intravenous heparinization requires admission to hospital for a prolonged period. Subcutaneous heparin therapy as used for the prophylaxis of venous thromboembolism has not been effective in the management of pregnant women with prosthetic heart valves (McLeod et al 1978).…”

Calcification of a Porcine Valve Xenograft during Pregnancy - A Case Report and Review of the Literature

“…The course of pregnancy in women with mechanical heart valve prostheses has been widely reviewed with relation to either mechanical valve complications (thromboembolism) or those associated with oral anticoagulant treatment (maternal or fetal), hemorrhage during labor and fetal malformation (4, 9,12,13,15,17,18,19).…”