TY - JOUR A2 - 科斯米，埃里希AU - 嘉美，英武AU - 胁，宇盟 - 村上，由美AU - 表参，玛雅AU - 原田，加代子AU - 福井，敦AU - 田中，博之AU - 泽井英明AU -柴原弘明PY - 2018 DA - 2018年7月29日TI - 6154382 VL - - 2018 AB - 在人工主动脉瓣与血栓孕妇造成严重的脑出血新生儿SP的情况下，许多患者，人工瓣膜后置换手术，接受华法林抗凝治疗。然而，据报道，在怀孕期间给予华法林可导致胎儿致畸。参照这种情况下，我们将讨论如何在妊娠中期给予华法林在新生儿造成了严重的脑出血。这位36岁的患者在这种情况下进行了主动脉瓣置换手术时，她才11岁;这需要在手术后继续使用华法林。虽然她被告知，否则，患者怀孕了。华法林治疗5周的妊娠被中断了，她开始肝素的自我注射;然而，她的健康急剧恶化需要紧急，华法林治疗。 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’s aortic valve. Because of this finding, we re-started 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 g 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. SN - 2090-6684 UR - https://doi.org/10.1155/2018/6154382 DO - 10.1155/2018/6154382 JF - Case Reports in Obstetrics and Gynecology PB - Hindawi KW - ER -