Arterial thrombosis in Pregnancy
We have discussed thrombosis in veins. What about thrombosis in the other group of vessels, the arteries?
Arterial thrombosis is a problem that is almost exclusive to one group of patients: those with artificial heart valves. If a person has heart valve disease, the defective valves may be replaced by mechanical valves. In such a case, life-long anticoagulant medication is instituted. This is because the presence of artificial valves poses a real risk of thrombosis and embolism.
In almost all cases, the anticoagulation takes the form of warfarin tablets, which are taken daily. If the affected woman becomes pregnant, medication will be changed to heparin, usually one of the low-molecular weight preparations, for the duration of the pregnancy.
If there is any laxity with the anticoagulation regime, arterial thrombosis is a real danger, with potentially life-threatening consequences.
Some physicians argue that, in cases of prosthetic heart valves, it is justified to continue using warfarin anticoagulation rather than risk switching to heparin. This is a very contentious argument and, while it has its merits, most experts hold that a switch to heparin is hardly ever problematic and can be smoothly phased in.
The only difficulty may be in persuading a patient who is used to painless tablets to come round to the idea of having to put up with injections for forty weeks, give or take.
Last update: January 13, 2013