A 28-year-old wom an w ho had had a m itral valve replacem ent for rheum atic heart disease 2 years.

A 28-year-old wom an w ho had had a m itral valve replacem ent for rheum atic heart disease 2 years ago had her suspected pregnancy con rm ed by a positive pregnancy test. Her current m edications include the anticoagulant warfarin (U.S. Food and Drug Adm inistration [FDA] category for teratogenic risk D) and am oxicillin (FDA category B). Which of the following would be the best course of action to be im plem ented by her fam ily physician? A. Stop all m edications throughout pregnancy B. Suspend warfarin for the rst trim ester of pregnancy C. Replace warfarin w ith heparin and continue am oxicillin D. Continue warfarin and replace am oxicillin w ith penicillin G E. Reduce the dose of warfarin and continue am oxicillin

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