Abstract

Anticoagulant therapy is becoming increasingly common in pregnant women for multiple indications. We discuss the problems associated with this therapy as to the choice between oral and parenteral anticoagulants and the management of the anticoagulated patient during labor and delivery. We present the case of a patient taking warfarin as an illustration. Specific treatment for the gravida taking heparin or warfarin who is to undergo elective or emergency vaginal delivery or cesarean section is reviewed, with emphasis regarding the warfarin anticoagulant effect on the fetus. The pharmacologic properties and side effects suggest that oral anticoagulants should be restricted or, ideally, withheld in pregnancy.