Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study

 

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dc.contributor.advisor Sliwa, Karen
dc.contributor.author Kariv, Sarah
dc.date.accessioned 2020-04-23T14:45:30Z
dc.date.available 2020-04-23T14:45:30Z
dc.date.issued 2019
dc.identifier.citation Kariv, S. 2019. Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study. . ,Faculty of Health Sciences ,Department of Medicine. en_ZA
dc.identifier.uri https://hdl.handle.net/11427/31685
dc.description.abstract 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.
dc.subject warfarin
dc.subject heparin, pregnancy
dc.subject anticoagulation
dc.subject mechanical heart valves
dc.subject Africa
dc.title Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study
dc.type Master Thesis
dc.date.updated 2020-04-23T01:19:17Z
dc.language.rfc3066 eng
dc.publisher.faculty Faculty of Health Sciences
dc.publisher.department Department of Medicine
dc.type.qualificationlevel Masters
dc.type.qualificationname MMed
dc.identifier.apacitation Kariv, S. (2019). <i>Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study</i>. (). ,Faculty of Health Sciences ,Department of Medicine. Retrieved from en_ZA
dc.identifier.chicagocitation Kariv, Sarah. <i>"Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study."</i> ., ,Faculty of Health Sciences ,Department of Medicine, 2019. en_ZA
dc.identifier.vancouvercitation Kariv S. Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study. []. ,Faculty of Health Sciences ,Department of Medicine, 2019 [cited yyyy month dd]. Available from: en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Kariv, Sarah AB - 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. DA - 2019 DB - OpenUCT DP - University of Cape Town KW - warfarin KW - heparin, pregnancy KW - anticoagulation KW - mechanical heart valves KW - Africa LK - https://open.uct.ac.za PY - 2019 T1 - Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study TI - Haemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study UR - ER - en_ZA


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