Features of the blood coagulation system in pregnant women with a mild and moderate course of COVID-19
Authors:   Shupyk National Healthcare University of Ukraine, Kyiv, Karlova O.O. ,   CNCE «Kyiv City Center of Reproductive and Perinatal Medicine», Ukraine, Balan A.V. ,   Shupyk National University of Healthcare of Ukraine, Kyiv,   CNCE «Kyiv City Center of Reproductive and Perinatal Medicine», Ukraine
Published: December 2024

One of the important issues today is the impact of the coronavirus disease on a woman's reproductive health, the course of pregnancy and childbirth. Careful observation of pregnant women with coronavirus disease showed abnormalities in the results of laboratory examinations of the blood coagulation system. This can lead to the development of more complications during pregnancy, pathological births and increase the percentage of perinatal mortality.
Aim - to study the impact of coronavirus disease on indicators of the blood coagulation system in pregnant women with a mild and moderate course of COVID-19.
Materials and methods. 120 pregnant women with a mild and moderate course of coronavirus disease were involved in the clinical and laboratory examination and belonged to the main group. The control group consisted of 40 women, whose pregnancy was not complicated by the coronavirus disease. The impact of coronavirus infection on indicators of the blood coagulation system was assessed by the results of platelet count and coagulogram (international normalized ratio, prothrombin time, prothrombin index, activated partial thromboplastin time, fibrinogen and D-dimer levels).
Results. The average value of D-dimer in the main group of pregnant women with coronavirus disease was 2841.25 ng FEO/ml. For perspective: the average value of D-dimer in the control group of pregnant women is 1368.55 ng FEO/ml. in the investigation of coagulogram indicators, the following average values were obtained in the main group: INR - 1.03; APTT - 28.75′; prothrombin time - 14.07′; total fibrinogen - 3.76 g/l; Prothrombin index - 102.18%. The following average values were obtained in the control group: INR - 0.98; APTT - 31.35′; prothrombin time - 13.92′; general fibrinogen - 3.52 g/l; Prothrombin index - 97.25%. The average value of the number of platelets in the main group was 201.2×109/l, and in the control group - 245.7×109/l.
Conclusions. In the case of a mild and moderate course of COVID-19, there are changes in the blood coagulation system in pregnant women, which is accompanied by a 2-fold increase in the level of D-dimer compared to control group. Changes in coagulogram indicators were noted in 34.17% of pregnant women in the main group, against 15% of pregnant women with changes in coagulogram indicators in the control group. COVID-19 negatively affects the course of the disease due to hypercoagulation, which significantly changes the homeostasis of pregnant women and worsens the condition of perinatal complications.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics. Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.