Prevention of thrombosis in pregnant women with suspected SARS‐CoV‐2 infection: clinical management algorithm

Ac, Lou-Mercadé; Gavín, Olga; Paulés, Cristina; Savirón-Cornudella, Ricardo; Mateo, Purificación; Ja, Páramo; Ruiz, S.

doi:10.1002/uog.22096

Cited by 11 publications

(11 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The chosen dosing was based on the literature review [ 27 , 44 , 45 ] and it has its background on given in the literature rate of the drug passing through the placenta to the fetus (feto-maternal ratio). Our results in this field will be addressed in another paper [ 46 ]. Nevertheless, complications that were related to digoxin toxicity were rare and mild.…”

Section: Discussionmentioning

confidence: 99%

Fetal Cardiac Interventions—Are They Safe for the Mothers?

Rebizant

Koleśnik

Grzyb

et al. 2021

JCM

View full text Add to dashboard Cite

The aim of fetal cardiac interventions (FCI), as other prenatal therapeutic procedures, is to bring benefit to the fetus. However, the safety of the mother is of utmost importance. The objective of our study was to evaluate the impact of FCI on maternal condition, course of pregnancy, and delivery. 113 mothers underwent intrauterine treatment of their fetuses with critical heart defects. 128 percutaneous ultrasound-guided FCI were performed and analyzed. The patients were divided into four groups according to the type of FCI: balloon aortic valvuloplasty (fBAV), balloon pulmonary valvuloplasty (fBPV), interatrial stent placement (IAS), and balloon atrioseptoplasty (BAS). Various factors: maternal parameters, perioperative data, and pregnancy complications, were analyzed. There was only one major complication—procedure-related placental abruption (without need for blood products transfusion). There were no cases of: procedure-related preterm prelabor rupture of membranes (pPROM), chorioamnionitis, wound infection, and anesthesia associated complications. Tocolysis was only necessary only in two cases, and it was effective in both. None of the patients required intensive care unit intensive care unit admission. The procedure was effective in treating polyhydramnios associated with fetal heart failure in six out of nine cases. Deliveries occurred at term in 89%, 54% were vaginal. The results showed that FCI had a negligible impact on a further course of pregnancy and delivery.

show abstract

Section: Discussionmentioning

confidence: 99%

Fetal Cardiac Interventions—Are They Safe for the Mothers?

Rebizant

Koleśnik

Grzyb

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…As a result, four patients (3, 4, 15 and 16) were not tested for SARS-CoV-2 infection at the time of delivery. Prophylactic treatment with low molecular weight heparin for 14 days was applied to COVID-19 women diagnosed by RT-PCR [24]. COVID-19 has been divided into three types [25]: asymptomatic infection refers no clinical symptoms or signs; mild infection refers symptoms such as fever, cough, headache, anosmia and asthenia; and severe infection refers dyspnea, hypoxemia accompanied by chest imaging compatible with pneumonia and respiratory infection.…”

Section: Methodsmentioning

confidence: 99%

High viral SARS-CoV-2 load in placenta of patients with hypertensive disorders after COVID-19 during pregnancy

Fabre¹,

Calvo

Ruiz

et al. 2021

Preprint

View full text Add to dashboard Cite

Introduction: Studies described an increased frequency of hypertensive disorders of pregnancy after a COVID-19 episode. There is limited evidence about SARS-CoV-2 viral load in placenta. This study aimed to investigate the relationship between SARS-CoV-2 viral load in placenta and clinical development of HDP after COVID-19 throughout different periods of gestation. Methods: This was a case-control study in women with and without gestational hypertensive disorders (HDP) after SARS-CoV-2 infection diagnosed by RT-PCR during pregnancy. Patients were matched by gestational age at the moment of COVID-19 diagnosis. We performed an analysis of SARS-CoV-2 RNA levels in placenta. Results: A total of 28 women were enrolled. Sixteen patients were diagnosed with COVID-19 during the third trimester and the remaining twelve patients in the others trimesters. Ten placentas (35.7%) were positive for SARS-CoV-2, nine of them (90%) belonged to the HDP group versus one (10%) in control group (p=0.009). Those cases with the highest loads of viral RNA developed severe-preeclampsia. Conclusion: The presence of SARS-CoV-2 was more frequent in placentas of patients with HDP after COVID-19. There seems to be a relationship between high viral load in the placenta and the development of hypertensive disorders. We found SARS-CoV-2 viral load in placenta after birth in mothers infected at the first half of pregnancy, but with negative nasopharyngeal RT-PCR at delivery. Our data suggest that SARS-CoV-2 infection during pregnancy could trigger gestational hypertensive disorders through placenta-related mechanisms.

show abstract

“…For women in which VTE is documented, AC should be continued until 6 weeks postpartum for a minimum of a total duration of 3 months since initiation. 57 , 58 …”

Section: Special Populationsmentioning

confidence: 99%

Anticoagulation for COVID-19 Patients: A Bird's-Eye View

Kreidieh

Temraz

2021

Clin Appl Thromb Hemost

View full text Add to dashboard Cite

Coronavirus disease 2019 (COVID-19) is a systemic disease that can be life-threatening involving immune and inflammatory responses, and that can result in potentially lethal complications, including venous thrombo-embolism (VTE). Forming an integrative approach to thrombo-prophylaxis and coagulation treatment for COVID-19 patients ensues. We aim at reviewing the literature for anticoagulation in the setting of COVID-19 infection to provide a summary on anticoagulation for this patient population. COVID-19 infection is associated with a state of continuous inflammation, which results in macrophage activation syndrome and an increased rate of thrombosis. Risk assessment models to predict the risk of thrombosis in critically ill patients have not yet been validated. Currently published guidelines suggest the use of prophylactic intensity over intermediate intensity or therapeutic intensity anticoagulant for patients with critical illness or acute illness related to COVID-19 infection. Critically ill COVID-19 patients who are diagnosed with acute VTE are considered to have a provoking factor, and, therefore, treatment duration should be at least 3 months. Patients with proximal deep venous thrombosis or pulmonary embolism should receive parenteral over oral anticoagulants with low-molecular-weight heparin or fondaparinux preferred over unfractionated heparin. In patients with impending hemodynamic compromise due to PE, and who are not at increased risk for bleeding, reperfusion may be necessary. Internists should remain updated on new emerging evidence regarding anticoagulation for COVID-19 patients. Awaiting these findings, we invite internists to perform individualized decisions that are unique for every patient and to base them on clinical judgment for risk assessment.

show abstract

Prevention of thrombosis in pregnant women with suspected SARS‐CoV‐2 infection: clinical management algorithm

Cited by 11 publications

References 3 publications

Fetal Cardiac Interventions—Are They Safe for the Mothers?

Fetal Cardiac Interventions—Are They Safe for the Mothers?

High viral SARS-CoV-2 load in placenta of patients with hypertensive disorders after COVID-19 during pregnancy

Anticoagulation for COVID-19 Patients: A Bird's-Eye View

Contact Info

Product

Resources

About