Yenidoğan Bir Bebekte Warfarin İlişkili İntrakranial Kanama: Vaka Sunumu

Öz

Warfarin, özellikle mekanik prostetik kalp kapağına sahip kişilerde tromboembolik olayların önlenmesinde yaygın olarak kullanılan bir antikoagülandır. Gebelik sırasında warfarin kullanımı konjenital anomali ve intrakranial kanama gibi ciddi komplikasyonlara neden olabilmektedir. Yenidoğanda warfarin ilişkili kanama, ender görülen bir komplikasyondur. Bu vaka sunumunda, mitral kapak rep- lasmanı nedeni ile yedi yıldır warfarin kullanan 29 yaşın- daki bir annenin bebeğinde meydana gelen intraventriküler ve subaraknoid kanama rapor edilerek gebelikte warfarin kullanımına dikkat çekilmek istendi

Anahtar Kelimeler

• Yenidoğan,warfarin,intrakranial kanama

Warfarin-Associated Intracranial Hemorrhage in a Newborn: Case Report

Öz

Warfarin is an anticoagulant which is frequently used in persons with mechanical heart valves at risk of thrombosis or embolism. Warfarin therapy during pregnancy can cause serious complications such as congenital malforma- tions and intracranial hemorrhage. Warfarin-associated neonatal bleeding event is a rare complication. Here, we report a neonate with intraventricular and subarachnoid hemorrhage whose 29- year- old- mother has used warfa- rin for seven years, because of mitral valve replacement. We want to draw attention to the use of warfarin during pregnancy with this case report

Anahtar Kelimeler

• Newborn,warfarin,intracranial hemorrhage

Kaynakça

1. Arya R. How I manage venous thromboembolism in preg- nancy. Br J Haematol 2011;153:698-708. http://dx.doi.org/10.1111/j.1365-2141.2011.08684.x PMid:21501137
2. Stevenson RE, Burton OM, Ferlauto GJ, Taylor HA. Hazards of oral anticoagulations during pregnancy. JAMA 1980;243:1549-51. http://dx.doi.org/10.1001/jama.1980.03300410037022 PMid:7359739
3. Chan WS, Anand S, Ginsberg JS. Anticoagulation of preg- nant women with mechanical heart valves: a systematic revi- ew of the literature. Arch Intern Med 2000;160:191-6. http://dx.doi.org/10.1001/archinte.160.2.191 PMid:10647757
4. Salazar E, Izaguirre R. Heart disease, anticoagulants and pregnancy. Rev Esp Cardiol 2001;54:8-16. PMid:11535183
5. van Driel D, Wesseling J, Sauer PJ, Touwen BC, van der Veer E, Heymans HS. Teratogen update: fetal effects after in utero exposure to coumarins overview of cases, follow-up findings, and pathogenesis. Teratology 2002;66:127-40. http://dx.doi.org/10.1002/tera.10054 PMid:12210474
6. Chan KY, Gilbert-Barness E, Tiller G. Warfarin embryo- pathy. Pediatr Pathol Mol Med 2003;22:277-83. http://dx.doi.org/10.1080/15227950307712 PMid:14692224
7. Mehndiratta S, Suneja A, Gupta B, Bhatt S. Fetotoxicity of warfarin anticoagulation. Arch Gynecol Obstet 2010;282: 335-7. http://dx.doi.org/10.1007/s00404-010-1369-5 PMid:20111969
8. Lee HC, Cho SY, Lee HJ, Kim CJ, Park JS, Chi JG. Warfarin-associated fetal intracranial hemorrhage: a case report. J Korean Med Sci 2003;18:764-7. PMid:14555837 PMCid:PMC3055110

9. Masamoto H, Uehara H, Mekaru K, Uezato T, Sakumoto K, Aoki Y. Warfarin-associated fetal intracranial hemorrhage in woman with mitral valve replacements: a case report. Am J Perinatol 2009;26:597-600. http://dx.doi.org/10.1055/s-0029-1220781 PMid:19404899
10. Cotrufo M, De Feo M, De Santo LS, et al. Risk of warfarin during pregnancy with mechanical valve prostheses. Obstet Gynecol 2002;99:35-40. http://dx.doi.org/10.1016/S0029-7844(01)01658-1