loading page

Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis
  • +7
  • Juliette Servante,
  • Gill Swallow,
  • James Thornton,
  • Bethan Myers,
  • Sandhya Munireddy,
  • Kinga Malinowski,
  • Maha Othman,
  • Wentao Li,
  • Keelin ODonoghue,
  • Kate Walker
Juliette Servante
Queen's Medical Centre Nottingham University Hospital NHS Trust

Corresponding Author:[email protected]

Author Profile
Gill Swallow
Queen's Medical Centre Nottingham University Hospital NHS Trust
Author Profile
James Thornton
Nottingham City Hospital
Author Profile
Bethan Myers
University Hospitals of Leicester NHS Trust
Author Profile
Sandhya Munireddy
University Hospitals of Leicester NHS Trust
Author Profile
Kinga Malinowski
Lunenfeld-Tanenbaum Research Institute
Author Profile
Maha Othman
Queen's University
Author Profile
Wentao Li
Monash University
Author Profile
Keelin ODonoghue
University College Cork
Author Profile
Kate Walker
University of Nottingham
Author Profile

Abstract

Background: As pregnancy is a physiological prothrombotic state, pregnant women may be at increased risk of developing coagulopathic and/or thromboembolic complications associated with COVID-19. Objectives: To investigate the occurrence of haemostatic and thrombo-embolic complications in pregnant women with COVID-19. Search Strategy: Two biomedical databases were searched between September 2019 and June 2020 for case reports and series of pregnant women with COVID-19. Additional registry cases known to the authors were included. Steps were taken to minimise duplicate patients. Selection criteria: Pregnant women with COVID-19 based either on a positive swab or high clinical suspicion e.g. symptoms and radiographic evidence. Data Collection and Analysis: 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. Main Results: 1063 women met the inclusion criteria, of which three (0.28%) had arterial and/or venous thrombosis, seven (0.66%) had DIC, and a further three (0.28%) 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%) maternal deaths in which DIC was reported as a factor in two. Conclusions: Our 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.