RT Journal Article SR Electronic T1 Management of anticoagulant therapy during pregnancy in patients with prosthetic heart valves JF Thorax JO Thorax FD BMJ Publishing Group Ltd and British Thoracic Society SP 206 OP 211 DO 10.1136/thx.26.2.206 VO 26 IS 2 A1 Jenkins, B. Stephen A1 Braimbridge, Mark V. YR 1971 UL http://thorax.bmj.com/content/26/2/206.abstract AB We describe two patients with Starr-Edwards mitral valve replacements who underwent pregnancy on oral anticoagulants and who were successfully delivered of live babies. The literature on pregnancy with prosthetic heart valves is reviewed. It is suggested that properly controlled oral anticoagulation should be continued until the onset of labour; the anticoagulant effect should then be reversed by an intravenous infusion of fresh-frozen plasma and the patient maintained on intravenous heparin injections six-hourly. Oral anticoagulants should be restarted immediately after delivery and the heparin withdrawn only when their effect has been re-established.