Warfarin in pregnacies wit Disadvantages of warfarin in cases with
artificial valves and Pregnancy: Which one to choose in pregnancy??? We are
aware that the dictum is to stop warfarin as soon as preg is diagnosed. And to switch
over to UFH upto 12 weeks. From 12-37 weeks one should use restart warfarin
(the cheap drug-easy for patient even in remote villages) and again switch over
to heparin from 37 weeks till delivery. In cases where vag delivery is planned
-- Heparin can be initiated again 6 hrs after Vag Delivery and for CS after 24
hrs. The problems of warfarin are A) It does
cross placenta B) It is not easily reversible C) INR have to be kept a little
higher range i.e. 2-3 times, whereas in case of Heparin it may be only 1.5 to
2.5. In preg Lab monitoring should be more frequent -better on weekly basis,
which can be infrequently done in case of UFH. Additionally miscarriage rate is
high with warfarin so also SB rate. But most of us prefer and bank on warfarin as this drug has to be
taken life longh artificial Cardiac valves??
No comments:
Post a Comment