[Anticoagulation's problematic during pregnancy in carriers of mechanical heart prosthesis].

INTRODUCTION: The heart prosthesis pregnant women are becoming more frequent due to the persistence of rheumatic fever in the country sends developments.

OBJECTIVE: To propose management strategies from preconception to pregnancy and postpartum.

MATERIALS AND METHODS: Prospective study from 2009-2014 about parturientes followed in cardiology and maternity on center Hospitalo University Oran.

RESULTS: Thirty patients were followed, ejection fraction was equal to 60% in 29 cases. A single case of stenosis of the aortic prosthesis. Sixteen received low molecular weight heparins (LMWH) enoxaparine kind between 6 and 12 weeks, 13 received l'acenocoumarol (AVK) in the first quarter. One patient had been insufficient dose enoxaparine to 1/day and complicate ischemic stroke, abortion of a fetus of 16 weeks malformed in a mother who received acenoucoumarol (AVK) in the first quarter. Maternal mortality was null.

DISCUSSION: LMWHs were 100% effective in sufficient doses, the VKA and LMWH relay period was critical and should be done in a hospital setting.

CONCLUSION: Wearing a prosthetic valve is compatible with supervised pregnancy LMWHs were 100% effective, provided they were used in sufficient doses between 6-12 weeks of amenorrhea.