Author + information
- Received April 24, 2016
- Revision received May 24, 2016
- Accepted June 6, 2016
- Published online October 18, 2016.
- aDepartment of Cardiology, Boston Children’s Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- bDepartment of Medicine, Division of Cardiology, Brigham and Women’s Hospital, Boston, Massachusetts
- cDepartment of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- ↵∗Reprint requests and correspondence:
Dr. Anne Marie Valente, Department of Cardiology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, Massachusetts 02115.
Pregnancy is associated with a hypercoagulable state. Women requiring anticoagulation need careful attention throughout pregnancy and the post-partum period. The choice of anticoagulant therapy, the degree of monitoring, and the therapeutic target should be modulated by balancing the risks and the benefits to the mother and fetus. Many of the available anticoagulant agents may be used safely in pregnancy, but they are disadvantaged by competing efficacy and risks to the mother and fetus. For example, vitamin K antagonists are the most efficacious for preventing mechanical valve thrombosis, but they pose risks to the fetus. Collaborative research that collects patient-level data will help clinicians navigate the intricate process of anticoagulation in pregnancy. Development of anticoagulant agents that are homogeneous, efficacious, safe to the fetus, and not affected by physiological perturbations of pregnancy will have tremendous effect on the outcomes of pregnancy in women who require anticoagulation.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 24, 2016.
- Revision received May 24, 2016.
- Accepted June 6, 2016.
- American College of Cardiology Foundation