Mechanical Valves and Pregnancy

From Ask Dr Wiki

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