Last Review Date: 11 April 2023

Evidence is limited regarding the prevalence and optimal management of pregnancy in individuals with mechanical heart valves (MHVs). Studies are scarce, often with small numbers of patients included. Mechanical valve thrombosis (MVT) occurs more frequently in pregnancy and there is a high risk of postpartum haemorrhage (PPH). There are a number of options for anticoagulation with differing risks to the pregnant individual and foetus. In the absence of high-quality data, this guideline aims to give recommendations using observational data, evidence from outside of pregnancy and expert opinion to address the key risks at different stages during pregnancy, at delivery and postpartum. Although no single strategy for anticoagulation can be recommended, key risks are identified with recommendations to optimise current management options.

A BSH Guideline on the Anticoagulant management of pregnant individuals with mechanical heart valves presented by Dr Will Lester.

Declaration of Interests

The BSH paid the expenses incurred during the writing of this guidance. All authors have made a full declaration of interests to the BSH and Task Force Chairs which may be viewed on request. WL has received speaker fees from Sanofi Aventis and Leo Pharma and speaker fees and attendance of advisory boards for Pfizer. CB has received speaker fees and financial support to attend scientific meetings from Sanofi Aventis and speaker fees and attendance of advisory boards for Pfizer.