孕期患者玻璃体内注射血管内皮生长因子（VEGF）抑制剂。
Intravitreal vascular endothelial growth factor (VEGF) inhibitor injection in patient during pregnancy.
作者信息
Kianersi Farzan, Ghanbari Heshmatollah, Naderi Beni Zahra, Naderi Beni Afsaneh
机构信息
Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Radiation Oncology, Shahrekord University of Medical Sciences, Shahrekord, Iran.
出版信息
J Drug Assess. 2021 Mar 15;10(1):7-9. doi: 10.1080/21556660.2020.1847926.
PURPOSE
To report the clinical course of a woman treated with intravitreal bevacizumab during pregnancy.
CASE REPORT
A 27-year-old female with poorly controlled diabetes and a history of two previous miscarriage was referred to our hospital with sudden deterioration in visual acuity (VA) in her right eye. Ocular findings revealed severe Proliferative Diabetic Retinopathy (PDR) complicated with preretinal hemorrhages in her right eye, and after maximal Panretinal Photocoagulation (PRP) bilaterally, she was treated with intravitreal injection of bevacizumab (IVB) into the right eye. Twenty four hours after the bevacizumab injection, she reported vaginal bleeding, and ultrasound confirmed a 12-week pregnancy of which the patient was unaware. The patient suffered from pregnancy loss.
CONCLUSION
Use of intravitreal anti-VEGF by pregnant woman may only be justified if the potential benefit outweighs the potential risk to the fetus and only if clearly needed. Intravitreal bevacizumab during pregnancy in women with a history of miscarriage should be used with caution.
目的
报告一名在孕期接受玻璃体内注射贝伐单抗治疗的女性的临床病程。
病例报告
一名27岁女性，糖尿病控制不佳，有两次流产史，因右眼视力突然下降被转诊至我院。眼部检查发现右眼患有严重的增殖性糖尿病视网膜病变并伴有视网膜前出血，在双眼进行最大程度的全视网膜光凝后，右眼接受了玻璃体内注射贝伐单抗（IVB）治疗。注射贝伐单抗24小时后，患者出现阴道出血，超声检查证实为12周妊娠，而患者此前并不知晓。该患者发生了流产。
结论
仅当潜在益处大于对胎儿的潜在风险且确实有明确需求时，孕妇使用玻璃体内抗血管内皮生长因子药物才可能是合理的。有流产史的女性在孕期使用玻璃体内贝伐单抗时应谨慎。
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