A DIFERENÇA NO MONITORAMENTO E MANEJO DE EVENTOS TROMBOEMBÓLICOS EM GESTANTES COM COVID-19

Autores

  • Maria Fernanda Brunetta de Almeida
  • Beatriz Rodrigues Neri
  • Gabrielle Benevides Lima
  • Mariana Barbosa Maciel Picanço

DOI:

https://doi.org/10.51161/rems/627

Palavras-chave:

Coagulopatias, COVID-19, Gravidez

Resumo

Introdução: A pandemia provocada pelo SARS-CoV-2 trouxe vários questionamentos científicos devido às alterações sistêmicas causadas pela doença, incluindo alterações na hemostasia. No caso da gravidez, há maior complexidade devido à fisiologia do estado hipercoagulável associado, com aumento de alguns fatores de coagulação. Isso demonstra a importância do tema para o estabelecimento de uma abordagem clínica-laboratorial apropriada para manejo das pacientes. Objetivo: Realizar uma revisão de literatura estabelecendo as diferenças no parâmetro de identificação laboratorial e esquema terapêutico de eventos tromboembólicos em gestantes com COVID-19. Material e métodos: Foi realizada uma revisão de literatura a partir da análise de dezenove (19) artigos científicos publicados entre abril e novembro de 2020. Destes, foram selecionados três (3), na base de dados do PubMed e Scielo, utilizando como termos de pesquisa: “COVID-19/Pregnancy” and “Coagulopathy”, terminologias de acordo com o sistema de Descritores em Ciências da Saúde (DeCS). Resultados: Coagulopatias por ativação dos fatores de coagulação ou cascatas fibrinolíticas podem ser desencadeadas por sepse, podendo causar eventos tromboembólicos ou hemorrágicos, que indicam mau prognóstico em pacientes com COVID-19. Nesse viés, na gravidez há um aumento fisiológico de fatores de coagulação, como o D-dímero e fibrinogênio, comprometendo o nível desses fatores como indicativo de prognóstico. Portanto, a Sociedade Internacional de Trombose e Hemostasia (SITH) recomenda testes rotineiros para avaliação dos níveis desses fatores em pacientes com COVID-19, e, especialmente em gestantes, é importante avaliar o tempo de tromboplastina parcial e fibrinogênio. Além disso, faz-se uma ressalva para gestantes no terceiro trimestre, que mesmo com a recomendação de aspirina profilática em casos especiais e para pacientes com COVID-19, estas devem cessar imediatamente, devido ao risco aumentado de hemorragia no momento do parto e puerpério. Conclusão: Desse modo, as informações evidenciam a importância de uma análise prognóstica e terapêutica individualizada para gestantes durante a pandemia da COVID-19.

Publicado

2021-02-01

Como Citar

Almeida, . M. F. B. de, Neri, . B. R., Lima, G. B., & Picanço, M. B. M. (2021). A DIFERENÇA NO MONITORAMENTO E MANEJO DE EVENTOS TROMBOEMBÓLICOS EM GESTANTES COM COVID-19. Revista Multidisciplinar Em Saúde, 2(1), 18. https://doi.org/10.51161/rems/627

Edição

Seção

Anais do Congresso Brasileiro de Hematologia Clínico-laboratorial On-line
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Dispatcher.dispatch(Object:Request) % line  281, file: PKPApplication.inc.php
PKPApplication.execute() % line   68, file: index.php

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