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COVID-19-Associated Coagulopathy in the Peripartum Setting: A Case Report

Ashley Allen1, Christine Hoang1, Roopina Sangha1

  • 1Department of Obstetrics and Gynecology, John Peter Smith Hospital, Fort Worth, Texas.

AJP Reports
|February 10, 2022
PubMed

Insights

COVID-19-induced coagulopathy in postpartum patients is difficult to manage. Further studies are needed to validate D-dimer and Sepsis-induced coagulopathy (SIC) scoring in this unique patient population.

Area of Science:

  • Critical Care Medicine
  • Obstetrics
  • Infectious Diseases

Background:

  • COVID-19-induced coagulopathy (CIC) management is challenging, particularly in the peripartum period.
  • Current diagnostic tools like Sepsis-induced coagulopathy (SIC) scoring and D-dimer levels have unclear utility in postpartum CIC.
  • Anticoagulation guidance for peripartum CIC remains ambiguous.

Observation:

  • A critically ill postpartum patient with COVID-19 developed acute respiratory failure.
  • The patient required mechanical ventilation and cesarean delivery, initially improving postoperatively.
  • Deterioration occurred on postoperative day 5, with a significantly elevated D-dimer (58 μg/mL), prompting escalated anticoagulation.

Findings:

  • The case highlights diagnostic and therapeutic challenges in managing CIC during the peripartum phase.
  • Elevated D-dimer levels were observed, necessitating increased anticoagulation therapy.
  • The patient ultimately succumbed to gram-positive bacteremia after prolonged ventilation.

Implications:

  • This case underscores the complexity of recognizing and managing CIC in postpartum women.
  • There is a critical need for research to validate D-dimer and SIC scoring in the peripartum population.
  • Establishing clear anticoagulation protocols for peripartum CIC is essential for improved patient outcomes.

Keywords:
COVID-19D-dimeranticoagulationcoagulopathyperipartum

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