Case of the Month #23 - obstetrics & SARS-CoV-2

Published 01/02/2022

What about thromboprophylaxis?

We know that patients with severe COVID-19 have increased incidence of thrombotic disease. Pregnant women are already physiologically at increased risk. One death described in the MBRRACE report resulted from a sagittal sinus clot despite appropriate prophylactic  anticoagulation. The RCOG advise that all pregnant women admitted to hospital with confirmed or suspected COVID-19 should receive prophylactic LMWH unless delivery is expected within the next 12 hours. Enhanced dosing in critical care cases should be part of an MDT discussion. This should extend until at least 10 days following hospital discharge (9).

Women who are asked to self-isolate at home are encouraged to stay active and mobile. A further risk assessment should be performed by maternity services with COVID-19 being an additional risk factor and LMWH provided if indicated.