{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:43:56Z","timestamp":1790419436517,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,12,26]],"date-time":"2016-12-26T00:00:00Z","timestamp":1482710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000325","name":"Wellbeing of Women","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the incidence of mechanical prosthetic heart valves (<jats:styled-content style=\"fixed-case\">MPHV<\/jats:styled-content>) in pregnancy in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>; rates of maternal and fetal complications in this group of women, and whether these vary with the anticoagulation used during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective descriptive population\u2010based study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>All consultant\u2010led maternity units in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>All women with an <jats:styled-content style=\"fixed-case\">MPHV<\/jats:styled-content> who were pregnant between 1 February 2013 and 31 January 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Collection and analysis of anonymous data relating to pregnancy management and outcome, using the <jats:styled-content style=\"fixed-case\">UKOSS<\/jats:styled-content> notification and data collection system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Maternal death, serious maternal morbidity, poor fetal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data were obtained for 58 women giving an estimated incidence of 3.7 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.7\u20134.7) per 100 000 maternities. There were five maternal deaths (9%); a further 24 (41%) suffered serious maternal morbidity. There was a poor fetal outcome from 26 (47%) pregnancies. Only 16 (28%) women had a good maternal and good fetal outcome. Low\u2010molecular\u2010weight heparin (<jats:styled-content style=\"fixed-case\">LMWH<\/jats:styled-content>) was used throughout pregnancy by 71% of women. Of these, 83% required rapid dose escalation in the first trimester. Monitoring regimens lacked consistency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study has estimated the incidence of <jats:styled-content style=\"fixed-case\">MPHV<\/jats:styled-content> in pregnant women in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>. It includes the largest cohort managed with <jats:styled-content style=\"fixed-case\">LMWH<\/jats:styled-content> throughout pregnancy reported to date. It demonstrates a high rate of maternal death, and serious maternal and fetal morbidity. Women with <jats:styled-content style=\"fixed-case\">MPHV<\/jats:styled-content>s, and their clinicians need to appreciate the significant maternal and fetal risks involved in pregnancy. Care should be concentrated in specialist centres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>High rates of poor maternal and fetal outcomes in pregnant women with mechanical prosthetic heart valves<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14478","type":"journal-article","created":{"date-parts":[[2016,12,26]],"date-time":"2016-12-26T07:13:00Z","timestamp":1482736380000},"page":"1411-1419","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":94,"title":["Pregnancy outcomes in women with mechanical prosthetic heart valves: a prospective descriptive population based study using the United Kingdom Obstetric Surveillance System (<scp>UKOSS<\/scp>) data collection system"],"prefix":"10.1111","volume":"124","author":[{"given":"S","family":"Vause","sequence":"first","affiliation":[{"name":"Obstetric Directorate St Mary's Hospital Central Manchester University Hospitals NHS Foundation Trust Manchester UK"},{"name":"Institute of Human Development Manchester Academic Health Science Centre University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Clarke","sequence":"additional","affiliation":[{"name":"Manchester Heart Centre Manchester Royal Infirmary Central Manchester University Hospitals NHS Foundation Trust Manchester UK"},{"name":"Institute of Cardiovascular Sciences Manchester Academic Health Science Centre University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CL","family":"Tower","sequence":"additional","affiliation":[{"name":"Obstetric Directorate St Mary's Hospital Central Manchester University Hospitals NHS Foundation Trust Manchester UK"},{"name":"Institute of Human Development Manchester Academic Health Science Centre University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CRM","family":"Hay","sequence":"additional","affiliation":[{"name":"Department of Haematology Manchester Royal Infirmary Central Manchester University Hospitals NHS Foundation Trust Manchester UK"},{"name":"Institute of Cancer Sciences Manchester Academic Health Science Centre University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Knight","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"(on behalf of UKOSS)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,26]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"448","article-title":"Pregnancy with prosthetic heart valves\u201430 years\u2019 nationwide experience in Denmark","volume":"40","author":"Sillesen M","year":"2011","journal-title":"Eur J Cardio\u2010thorac Surg"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-3848(11)70016-0"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.2.191"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00044-3"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03359.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crvasa.2012.06.003"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr218"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00609.x"},{"key":"e_1_2_6_10_1","volume-title":"British National Formulary","author":"Joint Formulary Committee","year":"2015"},{"key":"e_1_2_6_11_1","unstructured":"Health and Social Care Information Centre Statistics on Women's smoking at time of Delivery: England. 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