Dergiler / Southern Clinics of Istanbul Eurasia / 2020 / Cilt: 31 - Sayı: 3

Thromboprophylaxis in Covid-19 Positive Pregnant Women

Covid-19 Enfekte Gebelerde Trombofilaksi

Sayfa
281–286
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Therefore, starting LMWH treatment before Covid-19 infection progresses could be beneficial for preventing embolic complications that may be fatal.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Objective: Serious Covid-19 disease is often complicated by coagulopathy.
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Temel Bulgular & Veri:Most of Covid-19-related deaths have been shown to be caused by extensive intravascular coagula-tion disorders.
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Sonuç & Katkı:Therefore, starting LMWH treatment before Covid-19 infection progresses could be beneficial for preventing embolic complications that may be fatal.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Objective: Serious Covid-19 disease is often complicated by coagulopathy. Most of Covid-19-related deaths have been shown to be caused by extensive intravascular coagula-tion disorders. Our aim in this study is to examine the importance of thromboprophylaxis in Covid-19 positive pregnant women.Methods: Pregnant women diagnosed with Covid-19 with the polymerase chain reaction test were retrospectively analyzed and treatment processes were evaluated.Results: A total of 18 pregnant women were followed up with the diagnosis of Covid-19. The mean age of the patients was 28.90±5.26 (18–41). Laboratory results revealed high CRP levels (11/18), lymphocytopenia (10/18) and increased neutrophil percentage (14/18). CT examinations were reported as widespread involvement findings (ground glass opacities - GGO) in 3 of 8 patients and mild fibrotic changes in 5 of the patients. Thromboprophylaxis was not applied in 4 outpatients however applied in 9/14 of the hospitalized patients. The average duration of drug use is 7.1 days (1–14). Average hospital stay is 3.3 days (2–16). The preferred dose is 40 mg 1x1/day. In a patient with suspected pulmonary embolism, 60 mg of 2x1/day enoxaparin was used. Maternal, fetal, and hemorrhagic complications were not observed.Conclusion: Since there is a tendency to hypercoagulation in pregnancy, thromboembolic events are more common. Therefore, starting LMWH treatment before Covid-19 infection progresses could be beneficial for preventing embolic complications that may be fatal.

Abstract

Amaç: Ciddi Covid-19 hastalığı genellikle koagülopati ile komplike olmaktadır. Covid-19 ile ilişkili ölümlerin çoğunun yaygın intravasküler pıhtılaşma bozukluklarından kaynaklandığı gösterilmiştir. Bu çalışmada amacımız, Covid-19 enfeksiyonu olan gebe kadınlarda tromboprofilak-sinin önemini incelemektir.Gereç ve Yöntem: Polimeraz zincir reaksiyonu testi ile Covid-19 tanısı alan gebe kadınlar geriye dönük olarak incelendi ve tedavi süreçleri değerlendirildi.Bulgular: Toplam 18 gebe kadın Covid-19 tanısı ile takip edildi. Hastaların yaş ortalaması 28.90±5.26 (18–41) idi. Hastalar öksürük (7), nefes darlığı (7), ateş artışı (4), şiddetli miyalji (4), göğüs ağrısı (2) ve tat alma duyusu kaybı (1) ile hastaneye başvurdu. Laboratuvar sonuçlarında yüksek CRP düzeyleri (11/18), lenfositopeni (10/18) ve artmış nötrofil yüzdesini (14/18) görüldü. Bilgisayarlı tomografi incelemelerinde sekiz hastanın üçünde yaygın tutulum bulguları (buzlu cam opasiteleri - GGO) ve beşinde hafif fibrotik değişiklikler olarak bildirilmiştir. Dokuz hasta sezaryen ile doğurtuldu. Dört ayaktan takip edilen hastaya tromboprofilaksi uygulanmadı, ancak yatan hastaların 9/14'üne uygulandı. Ortalama ilaç kullanım süresi 7.1 gündür (1–14). Ortalama hastanede kalış süresi 3.3 gündür (2–16). Hastaların tedavisinde düşük molekül ağırlıklı heparin (LMWH) - enoksoparin tercih edildi. Tercih edilen doz 40 mg 1x1/gündür. Pulmoner emboli olduğundan şüphelenilen bir hastada 60 mg 2x1/gün enoksoparin kullanıldı. Maternal, fetal ve hemorajik komplikasyon gözlenmedi.Sonuç: Gebelikte hiper pıhtılaşma eğilimi olduğundan, tromboembolik olaylar daha yaygındır. Bu nedenle, Covid-19 enfeksiyonu ilerlemeden önce LMWH tedavisine başlamak, ölümcül olabilen tromboembolik komplikasyonları önlemek için yararlı olabilir.

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Bu Makaleye Atıf Yap

KOYUNCU, K., SAKİN, O., AKTAŞ, H. A., ŞAHİN, K., AYGÜN, T., ANĞIN, A. D., KALE, A. (2020). Thromboprophylaxis in Covid-19 Positive Pregnant Women. Southern Clinics of Istanbul Eurasia, Cilt: 31 - Sayı: 3, 281–286. https://ajindex.com/articles/313965

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