17 April 2025
: Case report 
Hypothyroidism and Double Mitral Lesion in Antiphospholipid Syndrome During Pregnancy: A Case Report
Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Adverse events of drug therapy, Clinical situation which can not be reproduced for ethical reasons, Rare coexistence of disease or pathology
José Manuel Madrazo Cabo A 1,2, Ania Villavicencio Flores BE 2, Paulina Chagollán Gudiño BE 2, Nuvia Adriana Monter Valera F 2, Jose Antonio Velasco Bárcena D 3, Virginia Sedeño Monge E 2*DOI: 10.12659/AJCR.945578
Am J Case Rep 2025; 26:e945578
Table 4. Cardiovascular drugs most commonly used during pregnancy [69].
| ACEI | They affect the renal development of the fetus, especially during the second and third trimesters of pregnancy. They should be avoided throughout pregnancy | |
| ARA II | Effect similar to ACE inhibitors. They should be avoided throughout pregnancy | |
| Amiodarone | It causes neonatal hypothyroidism and has also been associated with prematurity of neurodevelopment. They should be used during pregnancy only as a second-line drug in cases of resistance to other safer antiarrhythmics. If used, neonatal thyroid hormone levels should be carefully and regularly monitored | |
| Spironolactone | It has been linked to the risk of genital anomalies, and as a result, its use should be avoided during pregnancy. If a potassium-sparing diuretic is required, amiloride is preferable | |
| Acenocoumarins | They are related to warfarin embryopathy syndrome. Intracranial bleeding | |
| It has been used in high-risk patients to prevent preeclampsia | ||
| They can be used during pregnancy if necessary. Not in preeclampsia, as it has been pointed out that they can predispose to preeclampsia | ||
| They have been used extensively. A relationship with intrauterine growth retardation has been described, so monitoring with fetal biometry is recommended | ||
| Digoxin | Its use is safe (in therapeutic concentrations). Treatment of choice for fetal arrhythmias. It is safe during breast-feeding | |
| Calcium antagonists | Adenosine | Its use is safe for the treatment of SPT |
| Procainamide | Teatment of maternal and fetal arrhythmias. Its use as a long-term treatment is not recommended, given the incidence of pseudolupus | |
| Lidocaine flecainide | These have become the treatment of choice for fetal arrhythmias, especially in cases resistant to digoxin and complicated by hydrops fetalis | |
| angiotensin II receptor antagonists; : angiotensin-converting enzyme inhibitor, paroxysmal supraventricular tachycardia. | ||