The implications to women of  childbearing age taking Warfarin Anticoagulation

Gregersen, Nerine Evelyn

The implications to women of childbearing age taking Warfarin Anticoagulation

dc.contributor.author	Gregersen, Nerine Evelyn
dc.date.accessioned	2006-11-17T08:39:54Z
dc.date.available	2006-11-17T08:39:54Z
dc.date.issued	2006-11-17T08:39:54Z
dc.description	Faculty of Health Sciences School of Patholgy 8601804k erine.gregersen@nhls.ac.za	en
dc.description.abstract	The oral anticoagulant, warfarin, when administered in pregnancy, can cause warfarin embryopathy, fetal central nervous system abnormalities, spontaneous abortion and fetal intrauterine death. Women with prosthetic heart valves usually require warfarin in pregnancy because of their high risk for thromboembolic complications. Anticoagulation regimens in pregnancy in these women aim to balance the fetal effects of warfarin with maternal risks of thromboembolism. This study was conducted by structured interview of 124 black urban South African women of childbearing age, who had at least one warfarin-exposed pregnancy. The study aimed to determine the pregnancy outcomes in this cohort, their awareness of the effects of warfarin in pregnancy, and what management practices, as reported by them, had occurred with regard to their anticoagulation in pregnancy and what genetic counselling they had received. There was a significant difference in outcome between warfarin-exposed and non-exposed pregnancies; 55.2% (123/223) of warfarin-exposed pregnancies ended in the birth of an abnormal baby, spontaneous abortion or intrauterine death. The warfarin embryopathy rate was estimated at 4.5 – 5.4%. Most women reported having been given information about warfarin in pregnancy, though their awareness about the personal and fetal effects of warfarin was often inaccurate. Of warfarin-exposed pregnancies, 95% were reportedly exposed during critical weeks six to ten of pregnancy, and >50% after 36 weeks. Only 5/124 (4%) interviewees had genetic counselling. Poor pregnancy outcomes, lack of awareness about the effects of warfarin in pregnancy, and management practices at odds with international regimens are all areas highlighted by this study that require urgent attention in this high-risk group of women.	en
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dc.identifier.uri	http://hdl.handle.net/10539/1838
dc.language.iso	en	en
dc.subject	Warfarin	en
dc.subject	Women	en
dc.subject	Childbearing Age	en
dc.subject	Genentic counselling	en
dc.subject	Pregnancy outcomes	en
dc.title	The implications to women of childbearing age taking Warfarin Anticoagulation	en
dc.type	Thesis	en