A 28-year-old woman with a mechanical mitral valve on warfarin attends the GP at 5 weeks of gestation. She has just discovered she is pregnant. Which ...

Question

A 28-year-old woman with a mechanical mitral valve on warfarin attends the GP at 5 weeks of gestation. She has just discovered she is pregnant. Which is the single most important prescribing consideration?

Accepted Answer

Urgent referral to a specialist in maternal medicine for transition to LMWH or dose-adjusted warfarin with close monitoring, balancing teratogenic risk against valve thrombosis risk

Answer

Continue warfarin throughout pregnancy as the risk of valve thrombosis outweighs fetal risk

Answer

Switch from warfarin to a direct oral anticoagulant (DOAC) such as rivaroxaban

Answer

Stop all anticoagulation in the first trimester and restart at 13 weeks

Answer

Switch to aspirin 150 mg daily for the first trimester

uk-drcog MCQ (SBA): Warfarin and Mechanical Valve in Pregnancy

A 28-year-old woman with a mechanical mitral valve on warfarin attends the GP at 5 weeks of gestation. She has just discovered she is pregnant. Which is the single most important prescribing consideration?