{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T04:01:50Z","timestamp":1748059310216,"version":"3.41.0"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Anticoagulant therapy prevents thrombosis and thromboembolic events in patients with mechanical heart valves. Bridging anticoagulation around the time of birth represents a unique challenge. Few retrospective reviews or case series exist examining peripartum outcomes with bridging anticoagulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>Review of peripartum and postpartum anticoagulation management, with a focus on postpartum complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Design: case series, single centre. Setting: Royal Brisbane and Women's Hospital, Australia between 1 January, 2000, and 1 August, 2022. Population: all pregnant women with mechanical heart valves (any type) who birthed. Main outcome measures: intrapartum and postpartum haemorrhage, thrombosis, thromboembolic complications, cardiac events, readmission, and maternal death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 18 women, with 23 births. Sixteen births were via caesarean section (70%). Fourteen women (61%) experienced at least one significant haemorrhagic complication, one woman required a peripartum hysterectomy, one woman experienced atrial fibrillation, and one had a valvular thromboembolic complication. No maternal cerebral thromboses or maternal deaths were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with mechanical heart valves who undergo bridging anticoagulation are associated with significant maternal morbidity. Most postpartum haemorrhagic complications were associated with bridging unfractionated heparin infusions in the first postnatal week. Bridging anticoagulation practices varied widely. Ongoing pooled data are required to inform evidence\u2010based guidelines for postpartum anticoagulation management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13897","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T07:23:27Z","timestamp":1730791407000},"page":"269-276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Haemorrhagic and thromboembolic outcomes in pregnant patients with mechanical heart valves who undergo interruption of anticoagulation for birth \u2013 A case series"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2539-757X","authenticated-orcid":false,"given":"Lily","family":"Aboud","sequence":"first","affiliation":[{"name":"Department of Obstetric Medicine Royal Brisbane and Women's Hospital  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Tanner","sequence":"additional","affiliation":[{"name":"Department of Obstetric Medicine Royal Brisbane and Women's Hospital  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Parsonage","sequence":"additional","affiliation":[{"name":"Department of Cardiology Royal Brisbane and Women's Hospital  Brisbane Australia"},{"name":"Australian Centre for Health Services Innovation Queensland University of Technology  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Lust","sequence":"additional","affiliation":[{"name":"Department of Obstetric Medicine Royal Brisbane and Women's Hospital  Brisbane Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0137-9935","authenticated-orcid":false,"given":"Leonie","family":"Callaway","sequence":"additional","affiliation":[{"name":"Department of Obstetric Medicine Royal Brisbane and Women's Hospital  Brisbane Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.015242"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S177547"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02299.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1205"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.105221"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18781"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_8_10_1","unstructured":"DolginM.Nomenclature and criteria for diagnosis of diseases of the heart and great vessels.1994Available from URL:https:\/\/api.semanticscholar.org\/CorpusID:85438168."},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14178"},{"volume-title":"Stata Statistical Software: Release 17","year":"2021","author":"StataCorp","key":"e_1_2_8_12_1"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12544"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001721-200307000-00006"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/S0022-3565(25)31738-6","article-title":"Pharmacokinetics of heparin. 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Studies of time dependence in rats","volume":"210","author":"Bjornsson TD","year":"1979","journal-title":"J Pharmacol Exp Ther"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875-9114.2011.01049.x"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13897","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T05:25:11Z","timestamp":1747977911000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,4]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/ajo.13897"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13897","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"type":"print","value":"0004-8666"},{"type":"electronic","value":"1479-828X"}],"subject":[],"published":{"date-parts":[[2024,11,4]]},"assertion":[{"value":"2024-07-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}