【摘要】 目的评价全孕期使用小剂量华法林对母儿的安全性。方法回顾性分析2001年7月至2012年6月在广东省人民医院产检、分娩的机械瓣置换术后患者妊娠结局,按照早期妊娠使用抗凝方法分为A、B两组:A组为妊娠6~11周6 d使用低分子肝素加12周后口服华法林;B组为全孕期口服华法林。结果 A组和B组发生难免流产(10.4%vs.9.2%,P>0.05)、早产(2.1%vs.2.6%,P>0.05)、产后出血(4.2%vs.3.9%,P>0.05)的比率比较,差异无统计学意义。所有孕妇未发生血栓-栓塞性疾病。两组死胎的发生率比较,差异无统计学意义(0 vs.1.3%,P>0.05)。两组均未发生新生儿死亡、新生儿颅内出血及与华法林相关的胎儿畸形。结论全孕期小剂量使用华法林抗凝治疗对母儿均安全,妊娠期需要产科及心内科密切合作,监护母胎情况能够使得母儿并发症减至最少。更多还原

【Abstract】 Objectives To evaluate the safety of very low dose of oral warfarin throughout pregnancy in patients with mechanical heart valve replacement. Methods A retrospective chart review of pregnancy in 199 women with mechanical valve prostheses in Guangdong General Hospital from July 2001 to June 2012 were studied. The main outcomes were major maternal complications and perinatal outcomes. All the patients were divided into 2 groups according anticoagulant therapy : patients in A group used enoxaparin in the first trimester and then oral warfarin after12 weeks of pregnancy; patients in B group took oral warfarin throughout pregnancy. Results Incidences of spontaneous abortion, premature delivery, postpartum hemorrhage between A group and B group had no significant differences(10.4% vs. 9.2%, P>0.05; 2.1% vs. 2.6%,P>0.05; 4.2% vs. 3.9%, P>0.05). Thrombotic complications did not occur in both groups. Incidence of intrauterine death had no significant difference between the two groups(0 vs.1.3%, P >0.05). There was no neonatal death, neonatal intracranial hemorrhage or abnormalities on warfarin occurred in the two groups. Conclusions Compliance with low dose of warfarin in women with mechanical heart valves is efficacy and safety for maternal and perinatal outcomes.更多还原