Abstract
Objectives: To discuss the stratification of maternal risk to thromboembolism, the characteristics of the anticoagulants indicated for its prevention and the therapeutic strategies in pregnant women with mechanical valve prosthesis at different moments of gestation. Methods: This article is a review of the literature on anticoagulation in pregnant women with mechanical valve prosthesis, through the search and analysis of available scientific data. Results and Discussion: The state of hypercoagulability, characteristic of pregnancy, potentiates the risk of thromboembolism in pregnant women with mechanical prostheses. Thus, anticoagulation should not be discontinued during gestation and puerperium. However, several complications are related to anticoagulant therapy, such as bleeding and abortion. There is also the risk of fetal malformations caused by the teratogenic effects of warfarin when used in the first trimester. Despite this fearsome effect, it is considered the most effective anticoagulant in the protection against thromboembolism. Heparins are possible alternatives, but less effective. Final considerations: The higher morbidity and mortality in these patients makes special care necessary, ranging from the choice of type of valve prosthesis in women of childbearing age, to clinical management during the pregnancy-pituitary cycle.