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Warfarin Phobia

Cardiac Services Department North West Armed Forces Hospital, PO Box 100, Tabuk, Saudi Arabia

I read with interest the article "Anticoagulation in patients with mechanical valves during pregnancy" published in your journal.¹ Our group recently, investigated this important issue.² Up till now there is still no ideal mechanical valve or ideal method of anticoagulation specially in this subgroup of patients. With the new generation, less thrombogenic mechanical valves that may permit lower doses of anticoagulation, it is possible to continue warfarin during all the pregnancy. This regimen offer maximum patient compliance and minimal maternal morbidity and mortality with little increased risk of embryopathy.³ It seems that the risk of warfarin embryopathy is overestimated. A large randomized trial needed to prove or to disprove increased risk of warfarin therapy otherwise the clinician continue to have this phobia of advising their patients to continue oral anticoagulation through out all the pregnancy.

REFERENCES

1. Geelani MA, Singh S, Verma A, Nagah A, Betigeri V, Nigam M. Anticoagulation in patients with mechanical valves during pregnancy. Asian Cardiovasc Thorac Ann 2005;13:30–3.[Abstract/Free Full Text]

2. Hammad AM, Abdel-Aziz O, Elmistekawy EM, Serag AR. Serag AR. Anticoagulation in pregnant women with mechanical heart valves. J Saudi Heart Association 2004;16(3):215–9.

3. Vural KM, Ozatik MA, Uncu H, Emir M,Yurdagok O, Sener E et al. Pregnancy after mechanical mitral valve replacement. J Heart Valve Disease 2003;12:370–6.[Medline]

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Elsayed M Elmistekawy Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Elmistekawy, E. M Search for Related Content PubMed PubMed Citation Articles by Elmistekawy, E. M