Anticoagulation therapy after flap replacement in women of childbearing age is usually not significantly different from that of male patients, but differs in some special cases. 1, about menstruation: women with normal menstruation before surgery, oral anticoagulant after flap replacement, most patients have some changes in menstrual period and volume, the period is basically similar to that before surgery, the volume of menstruation can be slightly increased compared with that before surgery, the amount of anticoagulants used remains the same. Patients with regular functional uterine bleeding before surgery, postoperative anticoagulation in the menstrual period can be prolonged, the volume of menstruation can increase, but the cycle is basically unchanged, the dosage of warfarin can be reduced appropriately under the guidance of the doctor; if there is a lot of bleeding, menstrual disorders, continuous bleeding, other further treatment may be required. 2, on the issue of contraception: postoperative does not prevent marriage and sexual life, but it is recommended that 1 to 2 years after surgery, heart function fully recovered for good. Female patients should be contraceptive after marriage, the method can take oral contraceptives, or the application of contraceptive tools, or male sterilization, but should not choose the contraceptive ring, so as not to become a chronic inflammatory lesions. Patients taking oral contraceptives should pay attention to check the PT value and adjust the dosage in time to be safe. 3, on the issue of pregnancy: with the increase in the number of flap replacement surgery cases in women of childbearing age, the issue of pregnancy has gradually attracted attention. The reason is that pregnancy is a risk factor imposed on the mother and the fetus, and the main reason is that coumarin anticoagulants are teratogenic and increase the risk of intrauterine bleeding and fetal death, in addition to cardiac function. The mother is at risk for thromboembolism due to possible bleeding or a hypercoagulable state of the blood after pregnancy. In recent years, due to improvements in prosthetic valves, advances in surgical techniques, continuous improvement in anticoagulation management, strict control of indications, and close monitoring during pregnancy, the incidence of complications in mothers and infants has been significantly reduced. Therefore, it is best to avoid pregnancy and childbirth in women after valve replacement, but if any woman desires to have children, pregnancy should be allowed under the guidance and monitoring of a specialist after at least 1 year of valve replacement (usually 2-3 years), when hemodynamics and cardiac function have improved significantly and the systemic condition is good. During pregnancy, PT should be checked regularly and the dosage should be adjusted appropriately to minimize the incidence of maternal and fetal risk. Warfarin can enter the placenta and there is a risk of fetal malformation when taken during the first trimester of pregnancy. In order to avoid the teratogenic effect of warfarin, it has been suggested that heparin anticoagulation should be switched to heparin during the first trimester (first 3 months) and 3 to 4 weeks at the end of pregnancy. We recommend that you should keep in frequent contact with an obstetrics and gynecology specialist during pregnancy to receive treatment and guidance. 4. Regarding termination of pregnancy: pregnancy is contraindicated for those with cardiac function grade III-IV. You should consult your doctor for health care guidance. For women who are not suitable for pregnancy, if they are already pregnant, it is best to terminate the pregnancy within the first 3 months of pregnancy. The procedure is easier and less harmful to the patient at this stage. The medication should be used under the guidance of a specialist. 5. Concerning delivery: Generally, hospitalization awaiting delivery 1 to 3 weeks before the expected date of delivery. If there is no special, some of them can be delivered successfully through vaginal delivery. If the cardiac function is above grade II and there are fetal and obstetric indications, caesarean section is feasible. To reduce labor hemorrhage and prevent embolism, stop taking warfarin and replace it with intravenous short-acting anticoagulant heparin 0.5 mg/kg/4 hours 3 days before the expected date of delivery, and stop using heparin 12 hours before surgery. In case of spontaneous delivery, heparin was discontinued at the beginning of labor, and PT and APTT were checked to be close to normal control levels, and elective cesarean section or spontaneous delivery could be performed. After birth, the infant will be given Vit k 10mg via umbilical vein, and the mother will start heparin intravenously if there is no bleeding after delivery and resume anticoagulation. The infant should not be breastfed because of the anticoagulant in breast milk. In addition, the blood coagulability of pregnant and breastfeeding women has changed significantly, and some patients need to increase the dose of anticoagulants. Therefore, such patients should pay attention to review.