To Anticoagulate or Not to Anticoagulate
37 year old G2P1001 female presented with elevated blood pressure and headache. Labs showed signs of hemolysis, elevated LFTs and thrombocytopenia, suggestive of HELLP syndrome as well as a positive asymptomatic COVID-19 test. She was subsequently taken for emergent C-section under general anesthesia. She encountered post-partum hemorrhage and post operatively became dyspneic with worsening anemia and hypofibrinogenemia, therefore did not receive post-operative thromboprophylaxis due to ongoing coagulopathy. A CXR showed signs of pneumonia due to COVID19 and a CTA showed multiple pulmonary emboli. This case discusses the challenges of thromboprophylaxis in the setting of a known coagulopathy.
Harley J, Khan H, Soto RG. To anticoagulate or not to anticoagulate. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/4841