Q: I am 33 years old and I had open heart surgery one year back for aortic root replacement. Since then I am taking anticoagulant acetrom (warfarin). I already have one child. Is it safe to become pregnant again? Please advise.

A:Pregnancy is well tolerated in valve replacement patients if the Left Ventricular function is reasonably good. However, the anticoagulant medications are critically important. In the first 3 months supervised low molecular weight heparin is essential otherwise the fetus can develop problems. Anticoagulant regimens are modified during the various phases of pregnancy. In short the pregnancy has to be properly planned and be under good medical supervision of the hospital where surgery was done.