{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:09:12Z","timestamp":1762474152799,"version":"build-2065373602"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,7,29]],"date-time":"2018-07-29T00:00:00Z","timestamp":1532822400000},"content-version":"vor","delay-in-days":209,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Obstetrics and Gynecology"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>Many patients, after artificial valve replacement surgery, receive warfarin anticoagulant therapy. However, it has been reported that warfarin administration during pregnancy can cause fetal teratogenicity. With reference to this case, we will discuss how warfarin administration in mid\u2010pregnancy caused severe cerebral hemorrhage in the newborn child. The 36\u2010year\u2010old patient in this case underwent aortic valve replacement surgery when she was 11 years old; this requires the continued use of warfarin after surgery. Although she was advised otherwise, the patient became pregnant. The warfarin treatment was discontinued at 5 weeks of gestation and she began self\u2010injection of heparin; however, her health quickly deteriorated requiring an emergency, warfarin treatment. On gestation week 21, she was admitted to our hospital with a high likelihood of a spontaneous abortion. A week later, transesophageal ultrasonography revealed a thrombus in the patient\u2019s aortic valve. Because of this finding, we re\u2010started warfarin administration. At 32 weeks of gestation, cardiotocography showed decreased fetal heart rate; thus, an emergency Cesarean section was performed. A baby was delivered, weighing 1,702\u2009g with an Apgar Score of 1 at 1 minute and 4 at 5 minutes. Cranial computed tomography of the infant showed bilateral intraventricular hemorrhage and ventricular dilation. In order to protect the mother and prevent hemorrhage in the newborn, it is recommended that a continuous heparin infusion should be administered to the pregnant woman after the 36th week of gestation. Regarding the impact on the infant, it is considered that continuous intravenous administration of heparin is safer during the third trimester of pregnancy. However, administration of heparin alone makes the preventive effect of thrombosis uncertain. When warfarin is administered in pregnancy, pregnancy management should be performed bearing the risk of fetal cerebral hemorrhage in mind.<\/jats:p>","DOI":"10.1155\/2018\/6154382","type":"journal-article","created":{"date-parts":[[2018,7,29]],"date-time":"2018-07-29T19:31:24Z","timestamp":1532892684000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Case of a Pregnant Woman with Thrombosis in an Artificial Aortic Valve Resulting in Severe Cerebral Hemorrhage in the Newborn"],"prefix":"10.1155","volume":"2018","author":[{"given":"Hidetake","family":"Kamei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8989-6998","authenticated-orcid":false,"given":"Yu","family":"Wakimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumi","family":"Murakami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Omote","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayoko","family":"Harada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Fukui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideaki","family":"Sawai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Shibahara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,29]]},"reference":[{"key":"e_1_2_5_1_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-88-0023"},{"key":"e_1_2_5_2_2","first-page":"940","article-title":"CCS Consensus Conference 2001 update: recommendation for the management of adults with congenital heart disease","volume":"17","author":"Therrien J.","year":"2001","journal-title":"Part I. Canadian Journal of Cardiology"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8545(05)70319-3"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.7134\/phlebol.23.39"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1220781"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-13-1178"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001145"},{"key":"e_1_2_5_8_2","first-page":"1153","article-title":"Guidelines for management of anticoagulant and antiplatelet therapy in cardiovascular disease","volume":"68","year":"2004","journal-title":"Circulation Journal"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.2.191"},{"volume-title":"Guidelines for Obstetrical Practice in Japan","year":"2014","key":"e_1_2_5_10_2"}],"container-title":["Case Reports in Obstetrics and Gynecology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/criog\/2018\/6154382.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/criog\/2018\/6154382.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2018\/6154382","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:04:45Z","timestamp":1762473885000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2018\/6154382"}},"subtitle":[],"editor":[{"given":"Erich","family":"Cosmi","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2018,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1155\/2018\/6154382"],"URL":"https:\/\/doi.org\/10.1155\/2018\/6154382","archive":["Portico"],"relation":{},"ISSN":["2090-6684","2090-6692"],"issn-type":[{"type":"print","value":"2090-6684"},{"type":"electronic","value":"2090-6692"}],"subject":[],"published":{"date-parts":[[2018,1]]},"assertion":[{"value":"2018-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6154382"}}