Deep venous thrombosis related to the pregnancy-puerperal cycle and physiopathological changes with the advent of COVID-19

Authors

DOI:

https://doi.org/10.33448/rsd-v10i15.23097

Keywords:

Deep Venous Thrombosis; Pregnancy; COVID-19.

Abstract

Objective: Evaluate the main risk factors for Deep Venous Thrombosis (DVT) in pregnant and postpartum patients and whether there is a relationship with COVID-19 with increased cases. Methodology: Systematic literature review, in which searches were performed on the electronic platforms PubMed, LILACS and Scielo, using the descriptors: deep venous thrombosis, pregnancy and COVID-19. Results: The sample resulted in 15 articles. 93.3% of the surveys state that women in the gestational or postpartum period are more likely to develop DVT due to physiological changes during the period, with 26.6% of the total studies showing risk factors for worsening the condition, such as heart disease, pregnancy and age older than 35 years, cesarean delivery, recent surgery, among others. No study reported an increased incidence of DVT cases in pregnant women infected with the SARS-CoV-2 virus, however 20% of the articles demonstrate an increase in the number of complications associated with infection, such as premature birth, abortion and fetal death. Conclusion: There are high risks for thrombotic events in pregnancy, especially in pregnant women with aggravating factors, such as the triggers of Virchow's triad (stasis, hypercoagulation and vascular damage), with the need for special attention to these patients. There is no established association between an increase in DVT cases with COVID-19 infection, and the prophylactic use of Low Molecular Weight Heparin (LMWH) is recommended in these patients, although more studies on the subject are needed due to the short time of disease onset.

References

Ahmed, S., Zimba, O., & Gasparyan, A. Y. (2020). Thrombosis in Coronavirus disease 2019 (COVID-19) through the prism of Virchow's triad. Clinical Rheumatology, 39(9), 2529–2543.

Barros, M. V. L., Pereira, V. S. R., & Pinto, D. M. (2012). Controvérsias no diagnóstico e tratamento da trombose venosa profunda pela ecografia vascular. Jornal Vascular Brasileiro, 11(2), 137-143.

Cardonne, C. T. M., Cantillo, K. M., Durades, T. M. P., & Lora, L. D. V. (2020). COVID-19 y embarazo: Una aproximación en tiempos de pandemia. MEDISAN, 24(4), 707-727.

D'Souza, R., Malhamé, I., Teshler, L., Acharya, G., Hunt, B. J., & McLintock, C. (2020). A critical review of the pathophysiology of thrombotic complications and clinical practice recommendations for thromboprophylaxis in pregnant patients with COVID-19. Acta obstetricia et gynecologica Scandinavica, 99(9), 1110–1120.

Ferrer-Oliveras, R., Mendoza, M., Capote, S., Pratcorona, L., Esteve-Valverde, E., Cabero-Roura, L., & Alijotas-Reig, J. (2021). Immunological and physiopathological approach of COVID-19 in pregnancy. Archives of gynecology and obstetrics, 304(1), 39–57.

Freire, J. F. B., Flores, S. S. T., & Guerrero, M. A. B. (2021). SARS-CoV-2 y enfermedad tromboembólica venosa. No todo es nuevo. Angiología, 72(6), 286-297.

Gámez-Gámez, L. N., Gámez-Borges, L. N., José-Sorrillo, L., & Quiala, H. A. M. (2021). Influencia de la COVID-19 en el embarazo desde la perspectiva de los cuidados intensivos. Revista Informacion Cientifica, 100(4), e3351.

Gunduz Z. B. (2021). Venous sinus thrombosis during COVID-19 infection in pregnancy: a case report. Sao Paulo Medical Journal, 139(2), 190–195.

Jevtic, S. D., Malinowski, A. K., Othman, M., & Kadir, R. A. A. (2021). Physician experiences in management of COVID- 19- associated coagulopathy in pregnancy: Communication from the ISTH SSC Subcommittee on Women's Health Issues in Thrombosis and Haemostasis. J. Thromb. Haemost. 19, 2539-2545.

Junior, N. M., Kingerski, F. N. M., Marioto, G. L., Viegas, F. A. F., Mesquita, S. F. S., & Perreto, S. (2013). Prevalência de trombose venosa profunda em paraplégicos de causa traumática. Jornal Vascular Brasileiro, 12(4), 271-277.

Llau, J. V., Ferrandis, R., Sierra, P., Hidalgo, F., Cassinello, C., Gómez-Luque, A., Quintana, M., Amezaga, R., Gero, M., Serrano, A., & Marcos, P. (2020). SEDAR-SEMICYUC consensus recommendations on the management of haemostasis disorders in severely ill patients with COVID-19 infection. Recomendaciones de consenso SEDAR-SEMICYUC sobre el manejo de las alteraciones de la hemostasia en los pacientes graves con infección por COVID-19. Revista espanola de anestesiologia y reanimacion, 67(7), 391–399.

Marques-Santos, C., Avila, W. S., Carvalho, R. C. M., Lucena, A. J. G., Freire, C. M. V., Campanharo, F. F., Rivera, M. A. M. R., Costa, M. E. N. C., & Castro, M. L. (2020). Posicionamento sobre COVID-19 e Gravidez em Mulheres Cardiopatas – Departamento de Cardiologia da Mulher da Sociedade Brasileira de Cardiologia – 2020. Arquivos Brasileiros de Cardiologia, 115(5), 975-986.

Méndez, D.N, & Núñez, D.C. (2011). Enfermedad tromboembólica venosa en el embarazo y puerperio. Enfoque de riesgo y diagnóstico. MEDISAN, 15(10), 1423-1441.

Méndez, D.N, & Núñez, D.C. (2011). Experiencia de 11 años en la enfermedad tromboembólica venosa en el período grávido puerperal. Revista Cubana de Obstetricia y Ginecología, 37(3), 300-311.

Montenegro, C. A. B., & Filho, J. R. (2018). Obstetrícia Fundamental (14th ed.). Guanabara Koogan.

Oliveira, A. L. M. L., & Maques, M. A. (2016). Profilaxia de tromboembolismo venoso na gestação. Jornal Vascular Brasileiro, 15(4), 293-301.

Oliveira, K., Oliveira, J., Wernet, M., Paschoini, M., & Ruiz, M. (2021). Período pós-parto e infecção pelo novo coronavírus: revisão de escopo. Revista Enfermagem UERJ, 29(1), e56037.

Pontes, D. M., Pimentel, L. G. B., & Carvalho, F. H. C. (2013). Eventos tromboembólicos na gestação e puerpério: revisão sistemática e recomendação atual. Revista Feminina, 41(1).

Ramírez-Calderón, F., Vásquez-Alva, R., Lazo-Gordillo, D.E., & Zamora-Chávez, S.C. (2018). Trombosis venosa profunda de miembro inferior en gestante del primer trimestre: Reporte de caso. Revista Peruana de Ginecología y Obstetricia, 64(3), 473-478.

Roever, L. (2017). Compreendendo os estudos de revisão sistemática. Rev. Soc. Bras. Clin. Med, 15(2), 127-130.

Rojas-Sanchez, A. G., Rosa, G. N., Mijangos-Mendez, J. C., & Campos-Cerda, R. (2014). Tromboembolia pulmonar en el embarazo y puerperio. Neumol. Cir. Torax, 73(1), 42-48.

Servante, J., Swallow, G., Thornton, J. G., Myers, B., Munireddy, S., Malinowski, A. K., Othman, M., Li, W., O'Donoghue, K., & Walker, K. F. (2021). Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis. BMC pregnancy and childbirth, 21(1), 108.

Yang, H., Wang, C., & Poon, L. C. (2020). Novel coronavirus infection and pregnancy. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 55(4), 435–437.

Published

27/11/2021

How to Cite

COSTA, M. T.; FERREIRA, G. M.; BARROS, L. M. de. Deep venous thrombosis related to the pregnancy-puerperal cycle and physiopathological changes with the advent of COVID-19. Research, Society and Development, [S. l.], v. 10, n. 15, p. e309101523097, 2021. DOI: 10.33448/rsd-v10i15.23097. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/23097. Acesso em: 22 nov. 2024.

Issue

Section

Review Article