Complications of the use of Warfarin during pregnancy and Fetal Warfarin Syndrome: Scientific Review

• DOI: https://doi.org/10.22533/at.ed.1594302422031

• Palavras-chave: Warfarin, Pregnancy, Fetal Warfarin Syndrome, Teratogenicity, Anticoagulation in Pregnancy

• Keywords: Warfarin, Pregnancy, Fetal Warfarin Syndrome, Teratogenicity, Anticoagulation in Pregnancy

• Abstract:

  Thromboembolism represents a significant cause of maternal morbidity and mortality during pregnancy, leading to the need for anticoagulant interventions in specific cases. Warfarin, a widely used oral anticoagulant, carries substantial risks when administered during pregnancy, including teratogenicity and the induction of fetal warfarin syndrome. This study aims to deepen the understanding of complications associated with the use of warfarin in pregnant women and explore the clinical characteristics of fetal warfarin syndrome through a comprehensive systematic review. Case reports and observational studies published between 2017 and 2022 were analyzed, selected from reliable databases, focusing on pregnant women exposed to warfarin and outcomes related to the fetus. The results indicate that exposure to warfarin, especially during the first trimester of pregnancy, is significantly associated with congenital malformations, highlighting nasal, neurological and skeletal abnormalities as the most common manifestations of fetal warfarin syndrome. This study reinforces the need for careful management strategies for women of reproductive age who require anticoagulation, highlighting the importance of safer therapeutic alternatives during pregnancy. Multidisciplinary collaboration is essential to optimize care and minimize risks, both for the mother and the fetus, given the complexity of anticoagulant management in this critical period.