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Coagulation conundrum in obstetric anesthesia with COVID-19
Anand Kuppusamy1, B Natarajan2, Belinda Cherian3
1Professor (Anaesthesiology), SRM Medical College Hospital & Research Centre, Chengelpet, Tamil Nadu, India.
Insights
The COVID-19 pandemic severely impacted maternal health, particularly for women with existing conditions. This case highlights the complex management of a pregnant patient with COVID-19, a prosthetic valve, and severe pre-eclampsia.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Cardiology
Background:
- The COVID-19 pandemic has significantly disrupted maternal healthcare globally, especially in developing nations.
- Indirect effects, such as missed follow-ups due to lockdowns, exacerbate risks for pregnant individuals with comorbidities.
- Lack of standardized protocols complicates the management of pregnant patients with COVID-19 and concurrent medical conditions.
Abstract:
Coronavirus disease (COVID-19) pandemic is an unprecedented public health calamity that has caused an immense setback to maternal health services in developing countries. In addition to morbidity and mortality caused by COVID-19 disease in parturient directly, the indirect adverse impact of lockdown imposed during pandemic causing loss of follow-up of patients with coexisting illness is significant. There are no standard protocols to manage COVID-19 patients with comorbid medical illness, who are not optimized during antenatal visits. We report an interesting case of an antenatal patient with COVID-19, with prosthetic aortic valve on warfarin with elevated International Normalized Ratio (INR) and severe pre-eclampsia, posted for emergency cesarean section.
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