Complicated pregnancy with a combination of immune thrombocytopenia and new coronavirus infection

• Zoya S. Rumyantseva
• Margarita A. Dizha
• Oleg P. Miklin
• Denis V. Kondratyuk
• Polina A. Yermachkova
• Alexandra N. Kravchenko

Abstract

Immune thrombocytopenia in pregnancy (ITP) and a new coronavirus infection caused by SARS-CoV-2 is classified as a high-risk group for the probability of hemorrhagic complications in both the mother and the newborn. Currently, the exact mechanism of immune impairment in COVID-19 is unknown, so the greatest attention should be paid to patients who already have a pathology of autoimmune etiology. Obstetric and perinatal risks in ITP have been extensively discussed in the studies. In the present article, we have analyzed data from domestic and foreign literary sources, citing clinical cases of a complicated course of immune thrombocytopenia in pregnant women with a new coronavirus infection. Our studies suggest that SARS-CoV-2 infection with severe ITP contributes to a severe course of the disease, including cases with a lethal outcome. The mechanism is due to changes in hemostasis, direct damage to the vascular endothelium, causing its dysfunction and associated impaired clotting potential. The severity of the course of ITP in pregnant women and unsatisfactory perinatal outcomes depend on the severity of clinical manifestations and COVID-19 severity.

Keywords:immune thrombocytopenia; new coronavirus infection; pregnancy; clinical case

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