COVID-19 coagulopathy in pregnancy: Critical review, preliminary recommendations, and ISTH registry—Communication from the ISTH SSC for Women’s Health

Rezan Abdul Kadir, Takao Kobayashi, Toshiaki Iba, Offer Erez, Jecko Thachil, Sajida Kazi, Ann Kinga Malinowski, Maha Othman

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: Novel coronavirus (SARS-CoV-2), which causes COVID-19, has thus far affected more than 15 million individuals, resulting in more than 600 000 deaths worldwide, and the number continues to rise. In a large systematic review and meta-analysis of the literature including 2567 pregnant women, 7% required intensive care admission, with a maternal mortality ~1% and perinatal mortality below 1%. There has been a rapid increase in publications on COVID-19–associated coagulopathy, including disseminated intravascular coagulopathy and venous thromboembolism, in the non-pregnant population, but very few reports of COVID-19 coagulopathy during pregnancy; leaving us with no guidance for care of this specific population. Methods: This is a collaborative effort conducted by a group of experts that was reviewed, critiqued, and approved by the International Society on Thrombosis and Haemostasis Subcommittee for Women's Health Issues in Thrombosis and Hemostasis. A structured literature search was conducted, and the quality of current and emerging evidence was evaluated. Based on the published studies in the non-pregnant and pregnant population with a moderate to high risk of bias as assessed by Newcastle-Ottawa scale and acknowledging the absence of data from randomized clinical trials for management of pregnant women infected with SARS-CoV-2, a consensus in support of a guidance document for COVID-19 coagulopathy in pregnancy was identified. Results and Conclusions: Specific hemostatic issues during pregnancy were highlighted, and preliminary recommendations to assist in the care of COVID-19–affected pregnant women with coagulopathy or thrombotic complications were developed. An international registry to gather data to support the management of COVID-19 and associated coagulopathy in pregnancy was established.

Original languageEnglish
Pages (from-to)3086-3098
Number of pages13
JournalJournal of Thrombosis and Haemostasis
Volume18
Issue number11
DOIs
StatePublished - 1 Nov 2020
Externally publishedYes

Keywords

  • COVID-19
  • COVID-19 pregnancy registry
  • pregnancy and coagulopathy
  • pregnancy and venous thromboembolism
  • thromboprophylaxis in pregnancy

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