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

dc.contributor.advisorSliwa, Karen
dc.contributor.authorKariv, Sarah
dc.date.accessioned2020-04-23T14:45:30Z
dc.date.available2020-04-23T14:45:30Z
dc.date.issued2019
dc.date.updated2020-04-23T01:19:17Z
dc.description.abstractObjective: 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.identifier.apacitationKariv, 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.chicagocitationKariv, 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.citationKariv, 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.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
dc.identifier.urihttps://hdl.handle.net/11427/31685
dc.identifier.vancouvercitationKariv 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.language.rfc3066eng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectwarfarin
dc.subjectheparin, pregnancy
dc.subjectanticoagulation
dc.subjectmechanical heart valves
dc.subjectAfrica
dc.titleHaemorrhage and Other Complications in Pregnant Women on Anticoagulation for Mechanical Heart Valves; a Prospective Observational Cohort Study
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMed
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
thesis_hsf_2020_Kariv_Sarah.pdf
Size:
4.43 MB
Format:
Adobe Portable Document Format
Description:
License bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
0 B
Format:
Item-specific license agreed upon to submission
Description:
Collections