Low-dose warfarin maternal anticoagulation and fetal warfarin syndrome
| Autor: | Ana R Sousa, Rita Barreira, Edmundo Santos |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Pregnancy Complications Cardiovascular 030204 cardiovascular system & hematology Lower risk Congenital Abnormalities Nasal hypoplasia 03 medical and health sciences 0302 clinical medicine Therapeutic index Nasal Cartilages Pregnancy medicine Humans Nasal Bone heterocyclic compounds cardiovascular diseases 030212 general & internal medicine Fetus business.industry Low dose Infant Newborn Warfarin Abnormalities Drug-Induced Anticoagulants General Medicine Fetal warfarin syndrome medicine.disease Reminder of Important Clinical Lesson Treatment Outcome Heart Valve Prosthesis Female business medicine.drug |
| Zdroj: | BMJ Case Reports. :bcr-2017 |
| ISSN: | 1757-790X |
| DOI: | 10.1136/bcr-2017-223159 |
| Popis: | Fetuses exposed to warfarin during pregnancy are at an increased risk of developing an embryopathy known as fetal warfarin syndrome or warfarin embryopathy. The most consistent anomalies are nasal hypoplasia and stippling of vertebrae or bony epiphyses. Management of pregnant patients on anticoagulation is challenging. Current guidelines suggest the use of warfarin if the therapeutic dose is ≤5 mg/day. We report the case of a newborn with signs of warfarin embryopathy born from a mother anticoagulated with warfarin due to mechanical mitral and aortic heart valves. Warfarin was required at the dose of 5 mg/day and was withheld without medical advice between weeks 8 and 10 with no other anticoagulation. The newborn presented with skeletal abnormalities and a ventricular septal defect that have not required specific treatment during the first year of life. Low-dose warfarin is associated with a lower risk of warfarin-related fetopathy but the risk of embryopathy seems unchanged. |
| Databáze: | OpenAIRE |
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