Mechanical Valves and Pregnancy

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High Risk Valves

  • Such as Starr Edwards, Bjork-Shiley in Mitral Position
  • Coumadin with INR 3-4.5 then IV heparin at 35 weeks with PTT (2.5-3.5 x)
  • Other option is SQ or IV Heparin for 12 weeks (PTT 2.5-3.5 x), then Coumadin to 35th week, then convert back to IV heparin

Low Risk Valves

  • SQ Heparin until 12th week (PTT 2-3x), then Coumadin with INR 2.5-3.5 until 35th week, then covert to SQ Heparin
  • Other option is SQ Heparin throughout pregnancy
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