COVID‐19 and acute coagulopathy in pregnancy

Abstract

The present COVID-19 pandemic due to SARS-CoV-2 novel coronavirus has resulted in high numbers of critically ill patients and deaths. 1 Emerging data on the maternal impact of COVID-19 suggest that the clinical course is similar irrespective of pregnancy. [2][3][4] However, despite these data, our report of two pregnancies with COVID-19-related, rapidly progressive coagulopathy may warrant caution.

Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS‐CoV‐2 infection among hospitalized pregnant women: A systematic review

“…Serum biochemistry results were reported in 37 studies encompassing 381 women respectively 4,5,9–11,13–15,17,18,20,21,25,29,30,33–36,39,41,44–50,53,56,57–60,63,66 . In this group, raised serum C‐reactive protein was reported among 275 (72.2%) women, lymphopenia among 179 (47.0%) women, and transaminitis among 93 (24.4%) women.…”

“…Six women had abnormal coagulation parameters, all of which were associated with critical infection and multi‐organ dysfunction; three of three women subsequently died 18,20,44,59 . Coagulation parameters returned to normal during the postpartum period among the three women who survived.…”

“…In addition, six women experienced postpartum hemorrhage (estimated blood loss >1000 mL), all of whom had undergone cesarean delivery. Three of these women had severe or critical COVID‐19: one had developed consumptive coagulopathy requiring treatment with fibrinogen concentrate, whereas the other two had mild COVID‐19 disease 18,20,32 …”

Severe maternal morbidity and mortality associated with COVID‐19: The risk should not be downplayed

“…All rights reserved course/outcome of COVID-19 in pregnant women. 10,11,12 On the other hand, it could also be possible that the highly adaptive immune system in pregnancy may be potentially advantageous in defending against the infection. Further studies are needed to answer these questions.…”

Laboratory Abnormalities in Pregnant Women with Novel Coronavirus Disease 2019

“…In addition, two articles that did not clearly report laboratory abnormalities were also excluded. Overall, a total of 11 articles with 173 pregnant patients were included, [8][9][10][11][12][13][14][15][16][17][18] among which 11 women had severe disease, and 2 women had critical disease. Most of the patients came from China, and one each came from Korea, the United States, Sweden, Iran, Peru, and Canada.…”