Heparin induced thrombocytopenia in pregnant lady with mechanical heart valves: A rare situation. How to manage?

Abstract Patients with prosthetic heart valves are at higher risk of thromboembolism and need anticoagulation prophylaxis. Pregnancy poses higher risk for the same and heparins can be used safely in these patients however there are many side effects of heparin therapy including heparin induced thrombocytopenia (HIT). Pregnancy with prosthetic valves developing HIT has never been reported. We report a case of one such patient who had a mechanical aortic and mitral valve prosthesis who developed HIT at term pregnancy and was managed perioperatively with fondaparinux.