Patients with prosthetic metallic valves received heparin in
the first trimester and this was converted to warfarin at 13 weeks
gestational age and then reconverted to heparin at 36 weeks
gestational age. Following initial assessment, patients who were
in NYHA functional class I and II were managed as outpatients
and followed up weekly. Those who were in NYHA class III and
IV were hospitalised mainly due to poor social circumstances
and the fact that most were referred from distant areas of the
province.