ArticleEuropean heart journal2026
Pregnancy with a prosthetic heart valve, thrombosis, and bleeding: the ESC EORP Registry of Pregnancy and Cardiac disease III.
Article in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Maternal, Valvular and Foetal Outcomes of Pregnancy Following Aortic Valve Replacement.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026Pooled it
- Valve replacement during pregnancy: literature review including new data from the Registry Of Pregnancy And Cardiac disease III.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Pooled it
- 2025 European Society of Cardiology guidelines for the management of cardiovascular disease and pregnancy : Statement of endorsement by the NVVC.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026Review
- Pregnancy- the ultimate cardiovascular stress test.NPJ cardiovascular health · 2026Review
- Practical Recommendations for Anticoagulation in Patients With Atrial Fibrillation.European journal of clinical investigation · 2026Review
- Long-term pediatric outcomes after first-trimester exposure to low-dose warfarin plus enoxaparin versus enoxaparin alone in pregnancies with mechanical heart valves: the KYBELE children study.BMC cardiovascular disorders · 2026Observational
- Maternal Cardiovascular Emergencies During Pregnancy and the Puerperium: Current Diagnostic Approach and Management.Medicina (Kaunas, Lithuania) · 2026Review
- Global disparities in the detection and management of rheumatic heart disease in pregnancy across endemic settings.Frontiers in surgery · 2026Review
- How to set up a pregnancy heart team.International journal of cardiology. Congenital heart disease · 2025Article
- Cardiovascular Disease in Pregnancy: When Two Hearts Beat as One.Diagnostics (Basel, Switzerland) · 2025Review
- Pregnancy Anticoagulation Management in a Patient With a Mechanical Heart Valve and Heparin-induced Thrombocytopenia.Journal of cardiothoracic and vascular anesthesia · 2025Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
BACKGROUND AND
aimsPregnancy in women with a prosthetic heart valve is considered high risk, primarily due to the need for effective anticoagulation. However, data on the relationship between anticoagulation practices and pregnancy outcomes are very limited.
methodsThe Registry of Pregnancy and Cardiac disease is a global registry that prospectively enrolled pregnancies in women with a prosthetic heart valve between January 2018 and April 2023. Detailed data on anticoagulation, including dosage and monitoring, and cardiovascular, pregnancy, and perinatal outcomes were collected.
resultsIn total, 613 pregnancies were included of which 411 pregnancies were in women with a mechanical valve and 202 were in women with a biological valve. The chance of an uncomplicated pregnancy with a live birth in women with a mechanical valve was 54%, compared with 79% in women with a biological valve (P < .001). Thromboembolic and haemorrhagic complications most frequently occurred when low-molecular weight heparin (LMWH)-based regimens were used. Valve thrombosis occurred in 24 (6%) women, and a prosthetic valve in mitral position was associated with valve thrombosis (odds ratio 3.3; 95% confidence interval 1.9-8.0). A thromboembolic event occurred in 12 (10%) women with anti-Xa monitoring and in 9 (21%) women without (P = .060). Foetal death occurred in 20% of all pregnancies.
conclusionsMore favourable outcomes were found in women with a biological valve compared with a mechanical valve. In women with a mechanical valve, the use of LMWH was associated with an increased risk of thromboembolic complications. A mitral prosthetic valve was identified as a predictor for valve thrombosis. The benefit could not be confirmed nor refuted, in terms of reduced thromboembolic events, from using anti-Xa level monitoring in women on LMWH.
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