FETAL RISKS DUE TO WARFARIN THERAPY DURING PREGNANCY

Abstract
Two mothers with heart valve prosthesis were treated with warfarin during pregnancy. In the first case a cesarean section was done 1 wk after replacement of warfarin with heparin. The baby died of cerebral and pulmonary hemorrhage. The 2nd mother had a male infant by cesarean section. The baby showed warfarin-induced embryopathy with nasal hypoplasia and stippled epiphyses (chondrodysplasia punctata). Nasal hypoplasia with or without stippled epiphyses has now been reported in 11 infants born to mothers treated with warfarin during the 1st trimester and a causal association is probable. In view of the risks to both mother and fetus in women with prosthetic cardiac valves it is recommended that therapeutic abortion be advised as the first alternative.