What is the risk status associated with a mechanical valve during pregnancy?

A mechanical valve during pregnancy is associated with intermediate risk for complications. This risk is primarily due to the need for anticoagulation to prevent thromboembolic events, as the presence of a mechanical valve increases the risk of blood clots. Managing anticoagulation is more complex during pregnancy due to physiological changes, as well as the increased risk of bleeding and the potential impact on both maternal and fetal health.

Women with mechanical valves must often transition from warfarin to heparin during pregnancy to reduce the risk of teratogenic effects associated with warfarin, especially in the first trimester. This transition presents additional risks of complications such as valve thrombosis, which can lead to morbidity for the mother and fetus.

While there are strategies to manage these risks, the overall assessment characterizes pregnant women with mechanical valves as being at intermediate risk rather than low or high risk, striking a balance between potential thromboembolic events and the challenges associated with anticoagulation management. This nuanced understanding is essential for guiding care in pregnant patients with mechanical heart valves.