Pregnancy in patients with prosthetic heart valves.

Pregnancy and delivery were analyzed in 23 women one to ten years after undergoing prosthetic heart valve replacement. The main points of management during pregnancy and delivery were cardiac management and management against thromboembolism. The functional status of the pregnant patients was grade I of the New York Heart Association criteria in eight, grade II in 13 and grade III and higher in two. There were seven patients during pregnancy and eight after delivery who required hospitalization and treatment for congestive heart failure. Thromboembolism was observed in two during pregnancy and puerperium. Five of the patients were not given anticoagulation therapy, but when thromboembolism developed, warfarin was administered. Warfarin therapy was given indefinitely to seven patients, and 11 were given massive dosages of dipyridamole. In the first two groups, four patients had episodes of thromboembolism.