Department of Obstetrics, Gynecology, Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Division of Gynecologic Oncology, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA.
J Obstet Gynaecol Res. 2021 Nov;47(11):4077-4080. doi: 10.1111/jog.14978. Epub 2021 Aug 22.
Over 26 million cases of coronavirus disease 2019 (COVID-19) have been reported in the United States with over 440 000 deaths. Despite COVID-19 vaccine approval, pregnant women were excluded from clinical trials. We report a case of immune thrombocytopenia in the first trimester, which occurred 13 days after initiating the COVID-19 vaccination series. Thorough evaluation, including hematology consultation, established the diagnosis. High-dose oral corticosteroids were started, and she was discharged home with significant improvement in platelet count on her fourth day of hospitalization with no subsequent complications. We advocate that the benefits of COVID-19 vaccination outweigh the risk of infection in pregnancy and that pregnant women should be included in clinical trials. Closer post-vaccination surveillance may be warranted in the pregnant population pending further data.
美国已报告超过 2600 万例 2019 年冠状病毒病（COVID-19）病例，死亡人数超过 44 万。尽管 COVID-19 疫苗获得批准，但孕妇仍被排除在临床试验之外。我们报告了首例 COVID-19 疫苗接种系列后 13 天发生在孕早期的免疫性血小板减少症病例。全面评估，包括血液学咨询，确立了诊断。开始使用大剂量口服皮质类固醇，住院第四天血小板计数显著增加，病情明显好转，出院回家，无后续并发症。我们主张 COVID-19 疫苗接种的益处超过妊娠感染的风险，孕妇应纳入临床试验。在等待进一步数据的情况下，孕妇人群可能需要更密切的疫苗接种后监测。
