Medical disorders in pregnancy: anticoagulation in valves: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Medical disorders in pregnancy: anticoagulation in valves

Sample item

A woman with a mechanical mitral valve on warfarin is pregnant. Which statement is correct?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Anticoagulation must continue throughout, with heparin replacing warfarin around delivery

Mechanical valves are highly thrombogenic, so anticoagulation cannot be stopped. Options include LMWH throughout (with anti-Xa monitoring) or warfarin at a low dose with switch to heparin before delivery. Warfarin is avoided in the first trimester at doses above 5 mg because of embryopathy, and near term because of fetal bleeding.

Option by option

  • A. Aspirin alone is enough

    Aspirin alone does not protect a mechanical valve.

  • B. Warfarin is safe in all trimesters, so no change is needed

    Warfarin crosses the placenta and is teratogenic.

  • C. Anticoagulation must continue throughout, with heparin replacing warfarin around delivery (correct)

    Correct. The strategy balances valve thrombosis against fetal risk.

  • D. Anticoagulation can be stopped completely during pregnancy

    Stopping entirely risks valve thrombosis and maternal death.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Anticoagulation must continue throughout, with heparin replacing warfarin around delivery. Mechanical valves are highly thrombogenic, so anticoagulation cannot be stopped.

Why is "Aspirin alone is enough" not the answer?

Aspirin alone does not protect a mechanical valve.

Why is "Warfarin is safe in all trimesters, so no change is needed" not the answer?

Warfarin crosses the placenta and is teratogenic.

Why is "Anticoagulation can be stopped completely during pregnancy" not the answer?

Stopping entirely risks valve thrombosis and maternal death.

What concept does this question test?

It tests Medical disorders in pregnancy: anticoagulation in valves in OBG. Options include LMWH throughout (with anti-Xa monitoring) or warfarin at a low dose with switch to heparin before delivery. Warfarin is avoided in the first trimester at doses above 5 mg because of embryopathy, and near term because of fetal bleeding.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Medical disorders in pregnancy: anticoagulation in valves?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.