Anticoagulation during pregnancy should derive benefit from recent advances
in anticoagulant therapy. Unfractionated heparin is at present the drug of
choice for most of the indications of thromboprophylaxis as well as for ac
ute venous thrombosis during pregnancy but it is likely that, in the near f
uture, low molecular weight heparins will supercede this anticoagulant in m
any indications. One particular indication is mechanical heart valves that
needs a high degree of anticoagulation. The anticoagulant of choice that ca
rries the best efficacy-risk ratio in this situation seems to be oral antic
oagulants. Pregnant women receiving anticoagulation should be considered as
high-risk patients that should be managed in specialized centres. They are
prone to bleeding complications that will mainly occur during delivery or
in the postpartum period. (C) 1999 Elsevier Science Ireland Ltd. All rights
reserved.