Background: The combinations between heart disorders and gestation could be challenging to the physician managing the mother and fetus together. Gestation afterward mechanical heart valve replacements require critical coagulation controlling. Specific consideration must be given to the incidence of complications throughout anti-coagulation treatment.
Objectives: was to evaluate the outcome of the antenatal, natal and postnatal outcome of women with prosthetic valve with pregnancy according to the local policies and protocols in our department.
Patients and methods: This study was a cohort one that was demonstrated at Obstetrics and Gynecology Department, Qena Faculty of medicine, South Valley University in the period between July 2019  to 30th of June 2020.
Results: The results of current study showed a positive correlation between dose of warfarin and  neonatal outcome as in group A ( 64% with good outcome , 11.8% misscarige) compared with group B (22.2% with good outcome 38.9% misscarige), and good fetal / neonatal outcome was observed in(42.9% )of cases. The miscariage rate was (25.7%). Congenital anomaly was seen in (8.6%). Furthermore, (22.9%) of pregnancies ended as IUFD.
Conclusion: Warfarin as an anticoagulant for pregnant women with prosthetic valve throghout pregnancy seems to be secure for the mothers due to a lesser occurrence of thromboembolic conditions than un-fractionated or lower-molecular-weight heparin. The fetal / neonatal outcome is good especially if doses not exceed 5mg.