The Course of Pregnancy in Patients with Artificial Heart Valves Treated with Dipyridamole

Abstract

Continuing improvements in cardiac surgery and a wider selection of young patients for prosthetic valve replacement mean that an increasing number of women of childbearing age will undergo such procedures and will also subsequently become pregnant. At present, most patients with prosthetic heart valves are treated with anticoagulant drugs for life. The main problem with anticoagulant therapy during pregnancy is fetal and maternal hemorrhage. Congenital anomalies have been described in infants born to mothers treated with coumarin derivatives during the first trimester of pregnancy. Dipyridamole is known to decrease the adhesiveness of platelets or their ability to aggregate. We report the successful outcome of four pregnancies in patients with Starr-Edwards prostheses who were treated with dipyridamole during their pregnancies.

Asymptomatic Coronary Artery Disease in a Pregnant Patient

“…Dipyridamole has also been used during pregnancy in conjunction with aspirin for patients with prosthetic heart valves. In one report, four normal pregnancies resulted in neonates of normal weight without congenital abnormalities [14]. Another report of eight patients included six live births (one with incurving fifth fingers bilaterally), one 13-week abortion, and a second abortion at 22 weeks after 9 weeks of warfarin therapy [15].…”