The treatment of @entity1 in childbearing age with a mechanical heart valve is a challenge for the medical staff. @entity1229 ( @entity1229 ) is considered to be a safe and effective anticoagulant for @entity1 with prosthetic heart valves. However, treatment during pregnancy poses many difficulties, especially during the first trimester, due to its ability to cross the placenta and its associated fetotoxicity. Treatment with heparin during the first trimester decreases the rate of @entity2241 , but increases maternal morbidity and mortality. @entity1229 therapy throughout pregnancy, which is common mainly in Europe, carries low rates of maternal complications and roughly six percent of @entity2241 . Several studies compared @entity1229 treatment throughout pregnancy versus treatment with heparin during the first trimester. The relationship between daily @entity1229 doses and the rate of @entity2241 was recently investigated. We report two cases of pregnant @entity1 with mechanical heart valves who were treated with heparin during the first trimester. Both underwent an emergency replacement of the prosthetic valve during the eighth week of pregnancy. In this article, we review the literature regarding anticoagulation therapy in pregnant @entity1 with prosthetic heart valves; the comparison between treatment with @entity1229 throughout pregnancy and heparin in the first trimester; and the relation of daily @entity1229 doses with the rate of @entity2241 . The two case reports demonstrate the common approach for therapy and the danger within it. In the discussion we present a new approach for treating pregnant @entity1 with prosthetic valve and guidelines for the medical staff.

[Anticoagulation in pregnant XXXX with prosthetic heart valve--a new approach for therapy].

@entity1 :: ('9606', 'Species') :: ['women', 'patients'] @entity2241 :: ('MESH:D005315', 'Disease') :: ['embryopathy'] @entity1229 :: ('MESH:D014859', 'Chemical') :: ['Coumadin', 'Warfarin', 'warfarin']
@entity1 :: (9606,Species) :: ['women']
