If you have atrial fibrillation, a common heart rhythm disorder (arrhythmia), you might need to alter how you manage your condition during your pregnancy. For instance, you might need to avoid certain medications during pregnancy.
You're at higher risk of developing blood clots in your heart if you have atrial fibrillation. Pregnancy increases your risk of developing blood clots in your legs. Taking blood-thinning medications during pregnancy can help reduce your risk of blood clots.
If possible, discuss your condition and medications with your doctor before you become pregnant. Pregnancy can make arrhythmias worse. However, it's also possible to develop atrial fibrillation during your pregnancy.
If you take certain blood-thinning medications such as warfarin (Coumadin, Jantoven), your doctor might recommend avoiding this medication during all or part of your pregnancy. Warfarin has been associated with pregnancy risks.
Other oral blood-thinning medications — including dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (Eliquis) — also shouldn't be taken during your pregnancy. There aren't enough studies to determine their effects and safety during pregnancy.
Your doctor might prescribe heparin, another blood-thinning medication, to prevent blood clots. This medication is usually given through a syringe inserted into the fat under the skin. Heparin has been shown in studies to be safe and effective during pregnancy.
However, you're still at risk of bleeding while taking heparin or other blood-thinning medications. If you notice indications of bleeding, contact your doctor.
Even when taking blood-thinning medications, you're at risk of developing blood clots during pregnancy. Watch for signs or symptoms of blood clots, such as chest pain or leg swelling. Contact your doctor immediately if you notice unusual signs or symptoms.
Blood-thinning medications are usually stopped during labor and delivery, unless you're at very high risk of blood clots.
Blood-thinning medications are generally restarted after delivery, at your doctor's instructions. However, certain blood-thinning medications might not be recommended if you're breast-feeding. Discuss with your doctor which blood-thinning medications are safe for you and your baby.
Jan. 09, 2019
- Heart disorders in pregnancy. Merck Manual Professional Version. http://www.merckmanuals.com/professional/gynecology_and_obstetrics/pregnancy_complicated_by_disease/heart_disorders_in_pregnancy.html?qt=heart%20disorders%20in%20pregnancy&alt=sh. Accessed April 8, 2016.
- Bauer KA. Use of anticoagulants during pregnancy and postpartum. http://www.uptodate.com/home. Accessed April 8, 2016.
- A patient's guide to prevention of blood clots during pregnancy: Use of blood-thinning drugs to prevent abnormal blood clots in the legs of pregnant women. American College of Chest Physicians. http://www.chestnet.org/Search#q/q=Antithrombotic%20Therapy%20and%20Pregnancy. Accessed April 8, 2016.
- What is atrial fibrillation? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/af/. Accessed April 8, 2016.
- Silversides C, et al. Supraventricular arrhythmias during pregnancy. http://www.uptodate.com/home. Accessed April 8, 2016.