VPB1417 - Venous thromboprophylaxis in 108 hospitalized pregnant women with COVID-19: Experience of a Public Hospital in Argentina from April 2020-July 2021.

Background: Coronavirus (COVID-19) infection is a pandemic caused by SARS-CoV-2, appeared in Wuhan, in November 2019 and in March 2020 in Argentina. Initially it predisposes patients to thrombotic disease. Pregnancy is a hypecoagulable state and the optimal thromboprophylaxis in pregnancy is unknown. We work with the available information adapted to our hospital requirements.

Aims: To describe 1. Venous thromboprophylaxis in hospitalized pregnant women with COVID-19 infection. 2. Maternal outcome.

Methods: 108 pregnant women were hospitalized between April 2020-july 2021 (6 in the Intensive Care Unit (ICU), 4 required mechanical ventilation, 6 in Medical Clinic Unit and the rest in the Obstetrics Unit, patients were not vaccinated). Median age 29 (range 16-41). Trimester 1st 3.7%(4); 2nd 15.7%(17); 3rd 79.7%(86) (>37 weeks: 47); postpartum 0.9%(1). Treatment: We elaborated local guides and low molecular weight heparin (LMWH) enoxaparin 40 mg/d was prescribed to all pregnant women with COVID-19 when hospitalized, 8 received intermediated doses and those more than 37 week received unfractionated heparin (UFH). Outpatient prolongation of thromboprophylaxis depends on risk stratification, those admitted to ICU continue with enoxaparin until delivery.

Results: 41 patients were discharged pregnant and 64 postpartum, 1 ectopic pregnancy and 2 abortions. There were neither maternal deaths nor venous thromboembolism(VTE) during the acute period of infection or during hospitalization. One women that was admitted to de ICU and require ARM with a BMI >40 and with LMWH developed a deep vein thrombosis 2 months later at 34 week of gestation and was anticoagulated with full doses of LMWH.

Conclusion(s): During the first period of COVID 19 infection in our country, hospitalized women received either LMWH enoxaparin at fixed doses of 40 mg/day or UFH if near delivery. No VTE or maternal death were observed during hospitalization. We suggest to continue VTE prophylaxis during the antenatal period in those patients admitted to ICU until delivery.