Intraoperative coagulopathy during cesarean section as an unsuspected initial presentation of COVID-19: A case report

Kelly Elizabeth Kinsey, Eric Ganz, Susan Khalil, Lois Brustman

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: The world's understanding of COVID-19 continues to evolve as the scientific community discovers unique presentations of this disease. This case report depicts an unexpected intraoperative coagulopathy during a cesarean section in an otherwise asymptomatic patient who was later found to have COVID-19. This case suggests that there may be a higher risk for intrapartum bleeding in the pregnant, largely asymptomatic COVID-positive patient with more abnormal COVID laboratory values. Case: The case patient displayed D-Dimer elevations beyond what is typically observed among this hospital's COVID-positive peripartum population and displayed significantly more oozing than expected intraoperatively, despite normal prothrombin time, international normalized ratio, fibrinogen, and platelets. Conclusion: There is little published evidence on the association between D-Dimer and coagulopathy among the pregnant population infected with SARS-CoV-2. This case report contributes to the growing body of evidence on the effects of COVID-19 in pregnancy. A clinical picture concerning for intraoperative coagulopathy may be associated with SARS-CoV-2 infection during cesarean sections, and abnormal COVID laboratory tests, particularly D-Dimer, may help identify the patients in which this presentation occurs.

Original languageEnglish
Article number481
JournalBMC Pregnancy and Childbirth
Issue number1
StatePublished - 24 Aug 2020


  • COVID-19
  • D-Dimer
  • Sars-CoV-2
  • cesarean section
  • coagulopathy


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