A Review of the Prevalence of Thromboembolic Complications among Pregnant Women Infected with COVID-19

Ariff, Nurul Syafiqah Mohd; Zaki, Izzati Abdul Halim; Noordin, Zakiah Mohd; Hussin, Nur Sabiha Md; Goh, Khang Wen; Ming, Long Chiau; Zulkifly, Hanis Hanum

doi:10.3390/jcm11195934

Cited by 3 publications

(1 citation statement)

References 47 publications

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“…Inadequate growth of the placenta and fetus during early pregnancy, along with the impact of COVID-19 on the mother's immune system, causes hemodynamic changes in the maternal reproductive system and increases the risk of bleeding, thromboembolism, and other pregnancy complications. The long-term prognosis of COVID-19-infected pregnant women is unclear and requires more detailed investigation (13,14).…”

Section: Discussionmentioning

confidence: 99%

Coagulopathies Related to COVID-19 Infection in Pregnant Woman: A Case Report

Yousefi,

Arjmandnia,

Arjmandnia

2024

Fertil Gynecol Androl

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Introduction: COVID-19 infection in pregnant women can increase the risk of complications, particularly coagulation disorders and mortality. Case Presentation: We reported a case of a 32-year-old pregnant woman infected with COVID-19. One day after admission for COVID-19 treatment, she underwent a cesarean section (C/S). About 30 hours after the C/S, the patient's hemoglobin levels dramatically dropped. An emergency ultrasound revealed abundant free fluid in the abdomen. Based on the ultrasound findings, the patient underwent a diagnostic laparotomy. During the laparotomy, two liters of blood with clots were found in the abdomen, but the source of the bleeding was inconclusive. Following the laparotomy, the patient was transferred to the intensive care unit (ICU) and received necessary blood products such as packed cells, antihemophilic factor, and fresh frozen plasma (FFP). After five days, the patient was discharged in good general condition. Conclusions: Early diagnosis of bleeding, prompt and skilled interventions, and careful monitoring of recently operated pregnant women with COVID-19 reduce the risk of hemorrhagic shock, maternal complications, and mortality.

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Section: Discussionmentioning

confidence: 99%

Coagulopathies Related to COVID-19 Infection in Pregnant Woman: A Case Report

Yousefi,

Arjmandnia,

Arjmandnia

2024

Fertil Gynecol Androl

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A prospective cohort study of pregnancy outcomes following antepartum infection with SARS-CoV-2

Doss,

Diveley,

Zhang

et al. 2024

Pregnancy Hypertension

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Hemostatic imbalance underlying preterm delivery in COVID-19 convalescent patients

Nikolaeva,

Korchagina,

Momot

et al. 2023

Akušerstvo, ginekologiâ i reprodukciâ

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Aim: to study the role of the hemostatic system in pretem delivery in pregnant women who have had COVID-19 in the gestation period from 14 to 16 weeks.Materials and Methods. A prospective single-center observational study was conducted by enrolling 63 pregnant women with verified COVID-19 at 14–16 weeks of gestation. The main group consisted of 37 patients with preterm birth (PB), comparison group – 26 patients labour activity that occurred at least at gestational age of 37 weeks. Clinical and anamnestic data and dynamic changes in fibrinogen and D-dimer level, activity of tissue factor (TF), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (t-PA), urokinase plasminogen activator (u-PA) were analyzed; thrombin generation assay (TGA) was performed.Results. It was found that severity of COVID-19 infection did not determine the timing of delivery that depended on patient comorbid condition. All PB observations (37 out of 63, 58.7 %) were caused by decompensated placental function manifested by acute obstetrical complications: increasing intrauterine fetal hypoxia (64.9 %) along with intrauterine growth retardation (51.4 %), severe preeclampsia (13.5 %) and premature abruption of the normally located placenta (5.0 %). In both study groups, COVID-19 experienced at 14–16 weeks of pregnancy was associated with coagulation and fibrinolytic imbalances. At the same time, at least 6 weeks post-COVID-19 infection, patients with PB had higher level of the “Peak thrombin” vs. comparison group (3050 vs. 2527 pmol/L; p = 0.0433). Also, patients with term vs. preterm delivery had TF activity decreased significantly: by 47.1% and 28.1%, respectively (p = 0.0546). Patients in preterm delivery group were characterized by fibrinolytic imbalance. At the first time point, suppressed fibrinolysis (PAI-1 level – 18.4 vs. 12.5 ng/ml in the comparison group; p = 0.0209) was concomitant with elevated level of u-PA (1.5 vs. 0.55 ng/ml in comparison group, p = 0.0015), which suggests a potential prolonged immunoinflammatory response in patients with PB. Magnitude of fibrinogen concentration and D-dimer level during post-COVID-19 follow-up study was within the reference values specific to gestational age.Conclusion. A significant increase in coagulation potential was found and verified by elevated activity of tissue factor and potential to thrombin generation in COVID-19 convalescent patients. In the case of preterm delivery, there was an imbalance in fibrinolysis system revealed by decreased blood fibrinolytic activity elevating along with increasing gestational age.

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A Review of the Prevalence of Thromboembolic Complications among Pregnant Women Infected with COVID-19

Cited by 3 publications

References 47 publications

Coagulopathies Related to COVID-19 Infection in Pregnant Woman: A Case Report

Coagulopathies Related to COVID-19 Infection in Pregnant Woman: A Case Report

A prospective cohort study of pregnancy outcomes following antepartum infection with SARS-CoV-2

Hemostatic imbalance underlying preterm delivery in COVID-19 convalescent patients

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