A woman with a mechanical mitral valve is booked for induction at 38 weeks. She is receiving therapeutic twice-daily low-molecular-weight heparin

Question

A woman with a mechanical mitral valve is booked for induction at 38 weeks. She is receiving therapeutic twice-daily low-molecular-weight heparin with anti-Xa monitoring and has no labour symptoms. Which peripartum anticoagulation plan is most appropriate?

Accepted Answer

Convert to intravenous unfractionated heparin in hospital before the planned delivery

Answer

Continue monitored therapeutic low-molecular-weight heparin until 24 hours before planned induction

Answer

Convert from low-molecular-weight heparin back to warfarin until labour begins

Answer

Replace therapeutic anticoagulation with aspirin during the final week before delivery

Answer

Stop therapeutic low-molecular-weight heparin before induction and leave the valve unbridged

Peripartum Cardiomyopathy — EECC MCQ

A woman with a mechanical mitral valve is booked for induction at 38 weeks. She is receiving therapeutic twice-daily low-molecular-weight heparin with anti-Xa monitoring and has no labour symptoms. Which peripartum anticoagulation plan is most appropriate?