Can one conceive while on anticoagulants post-heart surgery?

Question

Hello doctor,

I am a heart patient and have undergone two open-heart surgeries for valve replacement. My valve has been replaced with a mechanical heart valve, and I will be on anticoagulants for life. Currently, I am taking Acitrom. I would like to ask if it is possible for me to become a mother with these complications.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your concern in detail and will surely help you out. I will answer your question in detail with proper reasoning.

First of all, Acitrom (Acenocoumarol) is an anticoagulant (blood thinner) associated with certain complications. It can increase the risk of excessive bleeding during delivery and the postpartum period, as well as in various parts of the body. Second, Acitrom is considered a teratogenic drug, meaning it has the potential to cause birth defects or malformations in the baby.

However, none of these factors completely prevent you from becoming a mother. Pregnancy, in your case, is challenging, but it is certainly possible with proper precautions.

Now, the protocol to follow when a patient is on Acitrom and plans pregnancy is:

When a patient on Acitrom plans to conceive, Heparin injections are used for the first three months of pregnancy. This is done because Acitrom is teratogenic, and stopping it during the early stages helps prevent birth defects.
Acitrom is generally restarted after the first trimester (three months). By this time, the baby's major organ formation is complete, and Acitrom is less likely to harm the baby.
The pregnancy is then continued with Acitrom until 36 weeks of gestation.
At 36 weeks, the patient is switched back to Heparin injections to minimize the risk of bleeding complications during delivery.

In your specific case, considering your history of valve replacement and heart surgeries, the preferred mode of delivery would be a Cesarean section (C-section). Vaginal delivery can put stress on the heart, increasing the risk of heart failure. However, this is manageable, and C-sections are considered relatively safe in such situations.

The journey will undoubtedly require extra care, close monitoring, and constant consultation with your healthcare team, but becoming a mother is achievable for you.

I hope I solved your doubts.

All the best for your journey. I wish you all the best.

Thank you.