Lethal pulmonary embolism in a pregnant woman with severe acute respiratory syndrome coronavirus-2 receiving prophylactic anticoagulation: a case report

Abstract Background A limited number of studies have described thrombotic complications in pregnant women with COVID-19. Here we report on fatal pulmonary embolism in a pregnant woman with laboratory confirmed SARS-CoV-2 infection. Case presentation A 28-year-old Kazakh woman was hospitalized with m...

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Main Authors: Yuliya V. Perfilyeva, Saule B. Maukayeva, Yerbol M. Smail, Andrey M. Dmitrovskiy, Yekaterina O. Ostapchuk, Andrey V. Zhigailov, Anna S. Nizkorodova, Zhanna A. Berdygulova, Dinara A. Naizabayeva, Anastassiya V. Perfilyeva, Elina R. Maltseva, Kulyan Zh. Kamytbekova, Yuriy A. Skiba
Format: Article
Language:English
Published: BMC 2023-11-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s13256-023-04180-w
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author Yuliya V. Perfilyeva
Saule B. Maukayeva
Yerbol M. Smail
Andrey M. Dmitrovskiy
Yekaterina O. Ostapchuk
Andrey V. Zhigailov
Anna S. Nizkorodova
Zhanna A. Berdygulova
Dinara A. Naizabayeva
Anastassiya V. Perfilyeva
Elina R. Maltseva
Kulyan Zh. Kamytbekova
Yuriy A. Skiba
author_facet Yuliya V. Perfilyeva
Saule B. Maukayeva
Yerbol M. Smail
Andrey M. Dmitrovskiy
Yekaterina O. Ostapchuk
Andrey V. Zhigailov
Anna S. Nizkorodova
Zhanna A. Berdygulova
Dinara A. Naizabayeva
Anastassiya V. Perfilyeva
Elina R. Maltseva
Kulyan Zh. Kamytbekova
Yuriy A. Skiba
author_sort Yuliya V. Perfilyeva
collection DOAJ
description Abstract Background A limited number of studies have described thrombotic complications in pregnant women with COVID-19. Here we report on fatal pulmonary embolism in a pregnant woman with laboratory confirmed SARS-CoV-2 infection. Case presentation A 28-year-old Kazakh woman was hospitalized with muscle pain, dry cough and a temperature of 37.5 °C at the 29th week of gestation. Upon admission, a blood test demonstrated elevated neutrophil-to-lymphocyte ratio, decreased levels of erythrocytes and hemoglobin, as well as prolonged prothrombin and activated partial thromboplastin time. Within 14 days of admission, she experienced respiratory distress and underwent transfer to the intensive care unit, intubation and a cesarean section. The patient received intravenous antibiotics, antiviral medications, systemic corticosteroids and dual anticoagulation with aspirin and enoxaparin. Death outcome was reported on day 18 of illness despite aggressive supportive care. Histological analysis demonstrated that obstruction of the main pulmonary arthery and disseminated intravascular coagulation were the causes of death. Conclusions This case demonstrates that in the management of pregnancy and childbirth in patients with suspected or confirmed COVID-19 infection, special attention should be paid to coagulation system parameters and timely appropriate prophylaxis of thromboembolic complications, which has yet to be determined.
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spelling doaj.art-d0374d8ad2bc4ffcb7afc2e70b0fb1f22023-11-26T13:26:15ZengBMCJournal of Medical Case Reports1752-19472023-11-011711810.1186/s13256-023-04180-wLethal pulmonary embolism in a pregnant woman with severe acute respiratory syndrome coronavirus-2 receiving prophylactic anticoagulation: a case reportYuliya V. Perfilyeva0Saule B. Maukayeva1Yerbol M. Smail2Andrey M. Dmitrovskiy3Yekaterina O. Ostapchuk4Andrey V. Zhigailov5Anna S. Nizkorodova6Zhanna A. Berdygulova7Dinara A. Naizabayeva8Anastassiya V. Perfilyeva9Elina R. Maltseva10Kulyan Zh. Kamytbekova11Yuriy A. Skiba12Almaty Branch of the National Center for Biotechnology, Central Reference LaboratorySemey Medical UniversitySemey Medical UniversityAlmaty Branch of the National Center for Biotechnology, Central Reference LaboratoryAlmaty Branch of the National Center for Biotechnology, Central Reference LaboratoryAlmaty Branch of the National Center for Biotechnology, Central Reference LaboratoryAlmaty Branch of the National Center for Biotechnology, Central Reference LaboratoryAlmaty Branch of the National Center for Biotechnology, Central Reference LaboratoryAlmaty Branch of the National Center for Biotechnology, Central Reference LaboratoryInstitute of Genetics and CytologyAlmaty Branch of the National Center for Biotechnology, Central Reference LaboratorySouth-Kazakhstan Medical AcademyAlmaty Branch of the National Center for Biotechnology, Central Reference LaboratoryAbstract Background A limited number of studies have described thrombotic complications in pregnant women with COVID-19. Here we report on fatal pulmonary embolism in a pregnant woman with laboratory confirmed SARS-CoV-2 infection. Case presentation A 28-year-old Kazakh woman was hospitalized with muscle pain, dry cough and a temperature of 37.5 °C at the 29th week of gestation. Upon admission, a blood test demonstrated elevated neutrophil-to-lymphocyte ratio, decreased levels of erythrocytes and hemoglobin, as well as prolonged prothrombin and activated partial thromboplastin time. Within 14 days of admission, she experienced respiratory distress and underwent transfer to the intensive care unit, intubation and a cesarean section. The patient received intravenous antibiotics, antiviral medications, systemic corticosteroids and dual anticoagulation with aspirin and enoxaparin. Death outcome was reported on day 18 of illness despite aggressive supportive care. Histological analysis demonstrated that obstruction of the main pulmonary arthery and disseminated intravascular coagulation were the causes of death. Conclusions This case demonstrates that in the management of pregnancy and childbirth in patients with suspected or confirmed COVID-19 infection, special attention should be paid to coagulation system parameters and timely appropriate prophylaxis of thromboembolic complications, which has yet to be determined.https://doi.org/10.1186/s13256-023-04180-wCOVID-19PregnancyPulmonary Artery EmbolismLethal Outcome
spellingShingle Yuliya V. Perfilyeva
Saule B. Maukayeva
Yerbol M. Smail
Andrey M. Dmitrovskiy
Yekaterina O. Ostapchuk
Andrey V. Zhigailov
Anna S. Nizkorodova
Zhanna A. Berdygulova
Dinara A. Naizabayeva
Anastassiya V. Perfilyeva
Elina R. Maltseva
Kulyan Zh. Kamytbekova
Yuriy A. Skiba
Lethal pulmonary embolism in a pregnant woman with severe acute respiratory syndrome coronavirus-2 receiving prophylactic anticoagulation: a case report
Journal of Medical Case Reports
COVID-19
Pregnancy
Pulmonary Artery Embolism
Lethal Outcome
title Lethal pulmonary embolism in a pregnant woman with severe acute respiratory syndrome coronavirus-2 receiving prophylactic anticoagulation: a case report
title_full Lethal pulmonary embolism in a pregnant woman with severe acute respiratory syndrome coronavirus-2 receiving prophylactic anticoagulation: a case report
title_fullStr Lethal pulmonary embolism in a pregnant woman with severe acute respiratory syndrome coronavirus-2 receiving prophylactic anticoagulation: a case report
title_full_unstemmed Lethal pulmonary embolism in a pregnant woman with severe acute respiratory syndrome coronavirus-2 receiving prophylactic anticoagulation: a case report
title_short Lethal pulmonary embolism in a pregnant woman with severe acute respiratory syndrome coronavirus-2 receiving prophylactic anticoagulation: a case report
title_sort lethal pulmonary embolism in a pregnant woman with severe acute respiratory syndrome coronavirus 2 receiving prophylactic anticoagulation a case report
topic COVID-19
Pregnancy
Pulmonary Artery Embolism
Lethal Outcome
url https://doi.org/10.1186/s13256-023-04180-w
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