Kazi Sajida, Othman Maha, Khoury Rasha, Bernstein Peter S, Thachil Jecko, Ciantar Etienne, Ferrara Laura, Netto Manju, Abdul-Kadir Rezan, Malinowski A Kinga
Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Queen's University, Kingston, Canada.
Obstet Med. 2024 Mar;17(1):13-21. doi: 10.1177/1753495X231206931. Epub 2023 Oct 16.
Concerns about COVID-19-associated coagulopathy (CAC) in pregnant individuals were raised in early pandemic.
An ISTH-sponsored COVID-19 coagulopathy in pregnancy (COV-PREG-COAG) international registry was developed to describe incidence of coagulopathy, VTE, and anticoagulation in this group.
All pregnant patients with COVID-19 from participating centers were entered, providing 430 pregnancies for the first pandemic wave. Isolated abnormal coagulation parameters were seen in 20%; more often with moderate/severe disease than asymptomatic/mild disease (49% vs 15%; < 0.0001). No one met the ISTH criteria for disseminated intravascular coagulopathy (DIC), though 5/21 (24%) met the pregnancy DIC score. There was no difference in antepartum hemorrhage (APH) with asymptomatic/mild disease versus moderate/severe disease (3.4% vs 7.7%; = 0.135). More individuals with moderate/severe disease experienced postpartum hemorrhage (PPH) (22.4% vs 9.3%; = 0.006). There were no arterial thrombotic events. Only one COVID-associated venous thromboembolism (VTE) was reported.
Low rates of coagulopathy, bleeding, and thrombosis were observed among pregnant people in the first pandemic wave.
在疫情早期，人们就对新冠病毒相关凝血功能障碍（CAC）在孕妇中的情况表示担忧。
建立了一个由国际血栓与止血学会（ISTH）赞助的孕期新冠病毒凝血功能障碍（COV-PREG-COAG）国际登记处，以描述该群体中凝血功能障碍、静脉血栓栓塞（VTE）和抗凝的发生率。
来自参与中心的所有新冠病毒感染孕妇均被纳入，为第一波疫情提供了430例妊娠数据。20%的孕妇出现孤立性异常凝血参数；在中/重度疾病患者中比无症状/轻度疾病患者中更常见（49%对15%；P<0.0001）。虽然5/21（24%）的患者符合妊娠弥散性血管内凝血（DIC）评分，但无人符合ISTH的DIC标准。无症状/轻度疾病患者与中/重度疾病患者在产前出血（APH）方面无差异（3.4%对7.7%；P=0.135）。中/重度疾病患者发生产后出血（PPH）的更多（22.4%对9.3%；P=0.006）。未发生动脉血栓事件。仅报告了1例新冠病毒相关静脉血栓栓塞（VTE）。
在第一波疫情期间，观察到孕妇中凝血功能障碍、出血和血栓形成的发生率较低。
