Pregnancy and Mechanical Mitral Valve

[YoginiL]

Hello Everyone,
I've been lurking a while but unable to post due to a glitch in registering. The webmaster remedied my problem, so here I am...
I'm 45 y.o. and into my 24th week of pregnancy (unplanned). This will be my first child. I had a mitral valve replacement (my 2nd) back in 2000 with a Carbomedics mechanical and my valve is functioning very well. I've been on warfarin thus far for my entire pregnancy and have had no problems to date. (side note: I'm aware of the potential teratogenic effects of warfarin, but, believe it or not, I didn't even realize I was pregnant until well into my first trimester--yeah, I'm an idiot-- so I was not able to consider the option of going on heparin during that critical period in fetal development; all I can do is keep my fingers crossed at this point). At any rate, as the spouse of a career Marine, I am receiving all my care at military medical facilities and, while pleased with the care I am receiving, none of my docs has direct clinical experience with a patient like me. At this point, my cardiologist and fetal maternal medicine specialist are working on a game plan for delivery, though I have a ways to go. My cardiologist sees no reason at this point why I shouldn't be able to have a normal delivery, but my fetal-maternal medicine specialist seems to be leaning more toward a planned c-section. They agree on getting me off coumadin around week 36 for bridge therapy on heparin (LMWH or UFH? I am not sure what they have in mind).
I know there are a few other folks on this board who have been through this high-risk adventure of pregnancy with a mechanical valve, either directly or as family members, and I would love to hear from them. Opinions, thoughts, suggestions, musings, etc. would be welcome. Thanks for listening,
Lauren

 

[Karlynn]

Welcome Lauren! I'm glad you joined us and wish you well with the rest of your pregnancy and delivery.

We have had 2 pregnancies with mechanical valve members this last year. Karen7 had a pretty successful go of it. Willow and Anthony (both members) also had a baby. Willow's pregnancy was frought with more complications. If you do searches under these 3 member names you should be able to read plenty of material.

Best wishes!

 

[geebee]

Welcome Lauren,

We do have a couple members who have been through pregnancies while on coumadin. Hopefully you will hear from them.

Having no children, I can't help with that but I did want you to know we are happy to have you posting.

I wish you well and please let us know how things progress for you.

 

[WayneGM]

Welcome, Lauren. Congratulations on your pregnancy. All the best.

 

[Flipper]

omg!!!! you can still have babies after a mechanical valve replacement??
this is wonderful news!!!!
i have been told over and over again that this was not possible and well here you are!!!
this is my first post in this forum. I am looking at some sort of surgery soon, replacement or repair, im not sure yet but this sure is great news!!!

 

[Karlynn]

Welcome Flipper. While pregnancy can be done while on a mechanical valve - it is pretty complicated. Do a search and look for posts by Anthony, Willow and Karen7. If you haven't had your valve replacement yet I would recommend speaking with your doctor about a tissue valve. Yes, it will mean another surgery for you, but it is the much more preferred valve for pregnancy. If you are otherwise cleared for pregnancy, getting a tissue valve will be the best way (in my opinion) to go through a pregnancy, if a repair isn't possible.

 

[YoginiL]

She's right...

She's right...

Welcome Flipper. While pregnancy can be done while on a mechanical valve - it is pretty complicated. Do a search and look for posts by Anthony, Willow and Karen7. If you haven't had your valve replacement yet I would recommend speaking with your doctor about a tissue valve. Yes, it will mean another surgery for you, but it is the much more preferred valve for pregnancy. If you are otherwise cleared for pregnancy, getting a tissue valve will be the best way (in my opinion) to go through a pregnancy, if a repair isn't possible.

Yes, it can be done, but pregnancy with a mechanical valve is fraught with increased risk for both mother and baby. I didn't intend to become pregnant, but it happened, so I just have to deal with the risk.
BTW, thanks to all those who responded. I will keep you posted as things progress.

 

[Mary]

Best wishes for an easy, successful delivery, Lauren.
One of my sisters became pregnant for the first time at the age of 41, and didn't realize it until she was five months along. She thought her periods had ceased due to menopause! She had a healthy baby boy, and then gave birth to a healthy daughter at the age of 45.
My youngest sister followed her example, and became pregnant, for the first time, at the age of 40. Now, two years later, she is pregnant again!
Let us know how you progress.
Mary

 

[YoginiL]

I can relate

I can relate

Best wishes for an easy, successful delivery, Lauren.
One of my sisters became pregnant for the first time at the age of 41, and didn't realize it until she was five months along. She thought her periods had ceased due to menopause! ...
Mary

Ok, I don't feel so bad now! This is exactly what was going through my mind, too. I had some bleeding during my first trimester, so I convinced myself it was just the very early phase of menopause with my cycle getting a little wacky.

Thanks for sharing...

 

[Mb]

Well, that is great new!

As a believer that all things happen on our journey for a reason, it sounds like you were truly meant to have this baby. May God watch over you, and the one you carry over the next months.

Marybeth

 

[Christina L]

Lauren -

Lauren -

Congratulations on your pregnancy and prayers will be with you that you deliver a healthy beautiful baby.

I cannot tell you much about Coumadin and pregnancy. I, also, have never borne a child myself, and am now 47 years of age and in the process of adopting a child from China. I never considered in vitro or anything like that -especially at my age and because of my heart (I had a mitral repair, but I still did not want to become pregnant because of it).

Because you weren't trying to conceive, I think this child of yours is meant to be - a gift from God. Best wishes to you. Keep us updated on your care - it sounds as if you are getting the best of medical care.

Christina L

 

[Flipper]

thanks for the info ladies. and best of luck!!

 

[abastos]

Lauren,
I would like to know more information about your pregnancy development. My wife is in a similar case and we are very worried. We have just discovered she is in the 9th week. She stopped warfarin immediately but 9 weeks have passed. She will be transferred to heparin in about one week if we decide to continue with the pregnancy. She takes warfarin due to a carotid dissection (FMD disease). We have 13 year-old twins, this is our second pregnancy. My wife is 43 years-old. Any thoughts, information, referrals, would be welcome. If you want to email me in private, my email is [email protected]
Thanks in advance,
Allan (abastos)

 

[lnfilo]

Hi Lauren, I hope everything went well with your pregnancy. Can you let me know the results of taking the warfarin throughout the entire pregnancy? I'm currently 11weeks pregnant and had a mitral valve replacement surgery about 12yrs ago. I'm currently taking Lovenox shots 3xs/daily and heavily contemplating switching back to the warfarin. I've read that the dose if warfarin has an impact on the fetus <5 less risk and >5 more, if you dont mind sharing the daily dose of warfarin you were taking throughout the pregnancy.

Thanks,
Leah