Obstetric history after mechanical cardiac valve replacement.

Results 45.7% had successful pregnancy outcome. 40% cases had missed abortion. Five patients chose to have Medical Termination of Pregnancy (MTP) with tubal ligation. The majority of subjects (76.4%) delivered within 5 years of valve replacement. Despite counselling about embryopathy all except one patient continued to take oral anticoagulants. There was no maternal mortality. Morbidity in the form of post-partum hemorrhage (8.5%), bleeding complications (5.7%) was observed. The incidence of preterm delivery was 14.3% and small for gestational age babies were 5.7%. There were no still births; one baby had malformations but was not consistent with features of embryopathy. Discussion/Conclusion Significant proportion of patients having valve replacement in our centre are females. Post-surgery their obstetric history is complicated by poor awareness about oral anticoagulation and its effect on pregnancy this results in delay in seeking appropriate obstetric care. In pregnancy there is an increased fetal wastage in patients taking oral anticoagulants though women with artificial valves can tolerate the hemodynamic load of pregnancy well. A successful pregnancy outcome in women with surgically corrected valve pathology involves preconception evaluation, counseling, close supervision during her pregnancy and labor.