A rare case of multiple thromboembolic events following valve replacement in pregnant women with rheumatic heart disease

Pregnancy is a hypercoagulable state. Women with mechanical valve replacement done falls under WHO 3 risk. Effective anticoagulation therapy is mandatory. Oral anticoagulants offer the best maternal protection against thrombosis, but associated with risk of fetal malformations and pregnancy loss. Oral anticoagulants offer the best maternal protection against thrombosis, but associated with risk of fetal malformations and pregnancy loss. A 26 years old primigravida, known case of rheumatic heart disease (RHD) since 11 years, post mechanical mitral valve replacement for severe mitral stenosis, referred with left upper limb ischemia, at 9 weeks gestation and managed accordingly