Family Planning and Pregnancy: US and Europe Perspectives
1:05:26-1:07:51
Q:
Do you have any women with Marfan who have also received a mechanical heart valve and are on blood thinners carrying a baby to term? You want to take that? Julie is nodding. Do you have an answer for that?
Eileen:
機械弁となったマルファン症候群の女性で、抗凝固療法を続けながら出産する方はいらっしゃるのでしょうか？De Backer先生がうなずいていらっしゃいますね。回答お願いします。
A:
Yes, I mean I can, I can answer. We have had women with mechanical valves going on Marfan disease going through pregnancy. As has been mentioned by by Melissa in her talk this needs to be addressed ahead of pregnancy.
Dr. De Backer:
私から回答します。そのような患者さんは複数名おられましたが、Russo先生のお話しにあったように妊娠前の対応が必要です。
There's, there's the detrimental effects of, of, the, of the anticoagulants that are needed in women with mechanical valves but there's, there's, algorithms, there's schemes that we can use for that purpose. What is important to know is that the teratogenics or the, the negative effect on a fetus is dose-dependent, so women who can have proper anticoagulation on relatively lower doses of, of anticoagulants can actually continue being on, on, on, on their regular anticoagulant regimen.
Dr. De Backer:
機械弁の患者さんにおいて服用が必要となる抗凝固薬には有害な作用があり、そうした影響を避けるための指標があります。重要なことは、胎児への催奇形性は薬の用量に依存するということです。比較的低用量の抗凝固薬を服用し、適切な抗凝固療法を受けている患者さんの場合には、通常の用量で妊娠を継続できます。
And in those women who need or who require higher doses of, of anticoagulants in the initial phase of pregnancy you will need to switch, so you will and there's options, there's, there's options to go for low-molecular-weight heparins, which are known to be less effective in avoiding thrombosis but still, I mean, if, there's a balance that you need to make there but it is, it is possible and what is important if, if there's a switch needed for low-molecular-weight heparin so these are, these are the the injections that you get, so, so I don't know, we, we have Fraxiparine, I don't know if the names are similar in, in other countries whatever. These are the the small injections that you need and what is important is that the, the, the dose is monitored so you need to monitor the level of, of, of, of the, the injections regularly and this is also according to schemes.
Dr. De Backer:
妊娠初期に高用量の抗凝固薬の投与が必要となる女性は、低分子量ヘパリンという薬に切り替えます。この薬は血栓の形成を抑える効果が低いことが知られており、注射による投与となりますが、用量の調整が必要です。他の国での名称はわかりませんが、こちらではFraxiparineです。少量の注射ではありますが、定期的に用量の検査をする必要があるということは覚えておいてください。こちらにも指針があります。
But it, it, well, the short answer to the question is yes. It is possible to go through pregnancy with a mechanical valve. It's, it's high risk, definitely but it is possible.
Dr. De Backer:
ご質問への簡潔な回答としては、機械弁でも出産は可能ということになりますが、確実にリスクは高まるということはご承知おきください。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
