what are the Recommendations for Anticoagulation for Pregnant Women With
Mechanical Prosthetic Heart Valves
Referenced studies that support the recommendations are
summarized in Online Data Supplement 44.?
Women with mechanical heart valves and their providers should use shared decision- making to choose an anticoagulation strategy for pregnancy. Women should be informed that VKA during pregnancy is associated with the lowest likelihood of maternal complications but the highest likelihood of miscarriage, fetal death, and congenital abnormalities, particularly if taken during the first trimester and if the warfarin dose exceeds 5 mg/d.