{"id":5415,"date":"2026-03-06T13:50:49","date_gmt":"2026-03-06T11:50:49","guid":{"rendered":"https:\/\/cvja.co.za\/journal\/?p=5415"},"modified":"2026-03-06T13:50:49","modified_gmt":"2026-03-06T11:50:49","slug":"cvja-2025-104","status":"publish","type":"post","link":"https:\/\/cvja.co.za\/journal\/cvja-2025-104\/","title":{"rendered":"Development of National Anticoagulation Guidelines for Pregnant Women with Mechanical Heart Valves in Rwanda"},"content":{"rendered":"
\r\n
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\r\n \r\n \r\nEmmanuel Rusingiza, Vongai Mlambo, Nicole Schulick, David Ntirushwa, Helen Mucyo, Esubalew Woldeyes Asfaw, Diomede Ntasumbumuyange, Sandra Havyarimana, Evariste Ntaganda, Ceeya Bolman, Yihan Lin\r\n<\/div> \r\n<\/div> \r\n
\r\n Copyright:<\/strong> Clinics Cardive Publishing (Pty) Ltd. publisher\r\n of Cardiovascular Journal of Africa.<\/div>\r\n
<\/div> \r\n
\r\n
\r\n Abstract \r\n <\/div> \r\n \r\n
\r\n \r\n \r\n \r\n \r\n\r\n Background:<\/strong> \r\n \r\nThe number of Rwandan women of reproductive age receiving mechanical heart valve prostheses for rheumatic heart disease is increasing. Effective anticoagulation management during pregnancy is essential to prevent valve thrombosis but poses significant risks to both mother and foetus if not carefully tailored.\r\n
\r\n\r\n Objective:<\/strong> \r\n \r\nThis article describes the multidisciplinary development of national guidelines for anticoagulation management in pregnant women with mechanical heart valves in Rwanda, integrating local clinical realities with international best practices.\r\n
\r\n\r\n Methods:<\/strong> \r\n \r\nGuideline development involved a three-stage process: (1) a stakeholder workshop to assess current practices and challenges, (2) iterative drafting and feedback from clinicians and policymakers, and (3) validation by representatives from key medical specialties. The process incorporated evidence from local studies, international guidelines, and the lived experiences of patients and providers.\r\n
\r\n \r\n Results:<\/strong> \r\nThe resulting guidelines emphasise preconception counselling, individualised risk assessment, and clear algorithms for adjusting anticoagulation regimens by gestational age. Practical considerations such as medication availability, laboratory capacity, and provider training are addressed to ensure feasibility in low-resource settings.\r\n
\r\n \r\n \r\n Conclusion:<\/strong> \r\n \r\nThese national guidelines aim to standardise anticoagulation management for pregnant women with mechanical heart valves in Rwanda, improving maternal and foetal outcomes. The approach provides a model for adapting evidence-based care to resource-limited environments.\r\n
\r\n \r\n\r\n \r\n <\/div> \r\n <\/div> \r\n \r\n \r\n
\r\n \r\n Keywords:<\/strong> \r\n \r\n rheumatic heart disease, anticoagulation, mechanical valve, pregnancy, Rwanda, practice guidelines<\/strong> \r\n \r\n <\/div> \r\n \r\n
\r\n \r\n Submitted:<\/strong> April 16, 2025; \r\n Accepted:<\/strong> October 16, 2025; \r\n Published:<\/strong> March 6, 2026
\r\n Cardiovasc J Afr 2025; 37<\/b>: 69-79<\/em>\r\n
Volume 37, Issue 1<\/strong>
\r\n <\/div> \r\n \r\n
\r\n DOI Citation Reference: dx.doi.org\/10.5830\/CVJA-2025-104 \r\n <\/div> \r\n \r\n
\r\n\r\n\r\nUniversity Teaching Hospital of Kigali, Kigali, Rwanda\r\n<\/strong>
\r\nEmmanuel Rusingiza
\r\nDavid Ntirushwa
\r\nHelen Mucyo
\r\nDiomede Ntasumbumuyange\r\n\r\n

\r\n\r\nUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda\r\n<\/strong>
\r\nEmmanuel Rusingiza
\r\nDiomede Ntasumbumuyange\r\n\r\n

\r\n\r\nStanford University School of Medicine, Palo Alto, California, USA\r\n<\/strong>
\r\nVongai Mlambo\r\n\r\n

\r\n\r\nUniversity of Colorado School of Medicine, Aurora, Colorado, USA\r\n<\/strong>
\r\nNicole Schulick\r\n\r\n

\r\n\r\nKing Faisal Hospital, Kigali, Rwanda\r\n<\/strong>
\r\nEsubalew Woldeyes Asfaw
\r\nSandra Havyarimana\r\n\r\n

\r\n\r\nRwanda Biomedical Centre, Kigali, Rwanda\r\n<\/strong>
\r\nEvariste Ntaganda, MD\r\n\r\n

\r\n\r\nTeam Heart, Kigali, Rwanda\r\n<\/strong>
\r\nCeeya Bolman\r\n\r\n

\r\n\r\nDepartment of Cardiothoracic Surgery, Stanford University, Palo Alto, California, USA\r\n<\/strong>
\r\nYihan Lin\r\n\r\n

\r\n \r\n\r\n [soshsc hide=\"logged\"]\r\n You need to be logged in to view and download<\/a> the full text PDF version. Register for a free account?<\/a><\/strong>

[\/soshsc]\r\n \r\n \r\n \r\n <\/div>\r\n \r\n<\/div>","protected":false},"excerpt":{"rendered":"

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