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Intraoperative coagulopathy during cesarean section as an unsuspected initial presentation of COVID-19: a case report.
Kinsey, Kelly Elizabeth; Ganz, Eric; Khalil, Susan; Brustman, Lois.
  • Kinsey KE; Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai West, 1000 10th Avenue, NY, New York, USA. kellyelizabeth.kinsey@mountsinai.org.
  • Ganz E; Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai West, 1000 10th Avenue, NY, New York, USA.
  • Khalil S; Division of Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Icahn School of Medicine, New York, USA.
  • Brustman L; Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai West, New York, USA.
BMC Pregnancy Childbirth ; 20(1): 481, 2020 Aug 24.
Article in English | MEDLINE | ID: covidwho-727268
ABSTRACT

BACKGROUND:

The world's understanding of COVID-19 continues to evolve as the scientific community discovers unique presentations of this disease. This case report depicts an unexpected intraoperative coagulopathy during a cesarean section in an otherwise asymptomatic patient who was later found to have COVID-19. This case suggests that there may be a higher risk for intrapartum bleeding in the pregnant, largely asymptomatic COVID-positive patient with more abnormal COVID laboratory values. CASE The case patient displayed D-Dimer elevations beyond what is typically observed among this hospital's COVID-positive peripartum population and displayed significantly more oozing than expected intraoperatively, despite normal prothrombin time, international normalized ratio, fibrinogen, and platelets.

CONCLUSION:

There is little published evidence on the association between D-Dimer and coagulopathy among the pregnant population infected with SARS-CoV-2. This case report contributes to the growing body of evidence on the effects of COVID-19 in pregnancy. A clinical picture concerning for intraoperative coagulopathy may be associated with SARS-CoV-2 infection during cesarean sections, and abnormal COVID laboratory tests, particularly D-Dimer, may help identify the patients in which this presentation occurs.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Pregnancy Complications, Hematologic / Pregnancy Complications, Infectious / Blood Coagulation Disorders / Breech Presentation / Cesarean Section / Blood Loss, Surgical / Coronavirus Infections Type of study: Case report / Diagnostic study / Prognostic study Language: English Journal: BMC Pregnancy Childbirth Journal subject: Obstetrics Year: 2020 Document Type: Article Affiliation country: S12884-020-03140-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Pregnancy Complications, Hematologic / Pregnancy Complications, Infectious / Blood Coagulation Disorders / Breech Presentation / Cesarean Section / Blood Loss, Surgical / Coronavirus Infections Type of study: Case report / Diagnostic study / Prognostic study Language: English Journal: BMC Pregnancy Childbirth Journal subject: Obstetrics Year: 2020 Document Type: Article Affiliation country: S12884-020-03140-2