Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis

BMC Pregnancy and Childbirth

Maha Othman¹  Gill Swallow²  Sandhya Munireddy³  Bethan Myers³  Wentao Li⁴  Juliette Servante⁵  Jim G. Thornton⁶  Kate F. Walker⁶  A. Kinga Malinowski⁷  Keelin O’Donoghue⁸ 

[1] Department of Biomedical and Molecular Sciences, School of Medicine, Queen’s University Kingston, Kingston, Ontario, Canada;School of Baccalaureate Nursing, St Lawrence College, Kingston, Ontario, Canada;Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK;Department of Haematology, University Hospitals of Leicester, Leicester, UK;Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia;Department of Obstetrics and Gynaecology, Nottingham University Hospitals NHS Trust, Nottingham, UK;Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK;Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada;The Irish Centre for Maternal and Child Health, University College Cork, Cork University Maternity Hospital, Cork, Ireland;

关键词: COVID-19;    SARS-CoV-2;    Pregnancy;    Birth;    Venous thrombosis;    Arterial thrombosis;    Coagulopathy;    Disseminated intravascular coagulopathy;    Haematological complications;   

DOI  :  10.1186/s12884-021-03568-0

来源: Springer

【 摘 要 】

BackgroundAs pregnancy is a physiological prothrombotic state, pregnant women may be at increased risk of developing coagulopathic and/or thromboembolic complications associated with COVID-19.MethodsTwo biomedical databases were searched between September 2019 and June 2020 for case reports and series of pregnant women with a diagnosis of COVID-19 based either on a positive swab or high clinical suspicion where no swab had been performed. Additional registry cases known to the authors were included. Steps were taken to minimise duplicate patients. Information on coagulopathy based on abnormal coagulation test results or clinical evidence of disseminated intravascular coagulation (DIC), and on arterial or venous thrombosis, were extracted using a standard form. If available, detailed laboratory results and information on maternal outcomes were analysed.ResultsOne thousand sixty-three women met the inclusion criteria, of which three (0.28, 95% CI 0.0 to 0.6) had arterial and/or venous thrombosis, seven (0.66, 95% CI 0.17 to 1.1) had DIC, and a further three (0.28, 95% CI 0.0 to 0.6) had coagulopathy without meeting the definition of DIC. Five hundred and thirty-seven women (56%) had been reported as having given birth and 426 (40%) as having an ongoing pregnancy. There were 17 (1.6, 95% CI 0.85 to 2.3) maternal deaths in which DIC was reported as a factor in two.ConclusionsOur data suggests that coagulopathy and thromboembolism are both increased in pregnancies affected by COVID-19. Detection of the former may be useful in the identification of women at risk of deterioration.

【 授权许可】

CC BY