Stuck mitral prosthesis in pregnancy – A challenge
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Rheumatic heart disease (RHD) has a high prevalence of 0.9/1000 in India among school children. Young females having undergone valve replacement when become pregnant face an uphill task of maintaining anti-coagulation required for prosthetic heart valve (PHV). Pregnancy being a hypercoagulable state, teratogenic effects of anticoagulant drugs and altered pharmacokinetics increase predisposition for PHV thrombosis, which in the presence of physiological changes of pregnancy may lead to life threatening situations, followed by a dilemma regarding the timing of delivery, replacement of the thrombosed PHV and risk of postpartum haemorrhage (PPH). We report the case of a patient who presented with stuck mitral prosthesis at 34 weeks of gestation, for which she underwent caesarean section (CS) followed by mitral valve replacement (MVR)....

http://www.joacc.com/article.asp?issn=2249-4472;year=2017;volume=7;issue=1;spage=60;epage=62;aulast=Gupta
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