Chang CH, Kao SP, Ding DC. Transient ischemic attack after mRNA-based COVID-19 vaccination during pregnancy: A case report. World J Clin Cases 2022; 10(27): 9929-9935 [PMID: 36186193 DOI: 10.12998/wjcc.v10.i27.9929]
Corresponding Author of This Article
Dah-Ching Ding, PhD, Chief Physician, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, 707, Sec. 3, Chung-Yang Road, Hualien 970, Taiwan. dah1003@yahoo.com.tw
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2022; 10(27): 9929-9935 Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9929
Transient ischemic attack after mRNA-based COVID-19 vaccination during pregnancy: A case report
Chi-Han Chang, Sheng-Po Kao, Dah-Ching Ding
Chi-Han Chang, Sheng-Po Kao, Dah-Ching Ding, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan
Author contributions: Ding DC, Kao SP, and Chang CH designed the research study; Ding DC, Chang CH performed the research; Ding DC and Chang CH analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: A written informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The authors have nothing to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dah-Ching Ding, PhD, Chief Physician, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, 707, Sec. 3, Chung-Yang Road, Hualien 970, Taiwan. dah1003@yahoo.com.tw
Received: May 23, 2022 Peer-review started: May 23, 2022 First decision: July 12, 2022 Revised: July 19, 2022 Accepted: August 11, 2022 Article in press: August 11, 2022 Published online: September 26, 2022
Abstract
BACKGROUND
Thrombocytopenia with thrombosis syndrome has been reported after vaccination against severe acute respiratory syndrome coronavirus 2 with two mRNA vaccines. The syndrome is characterized by thrombosis, especially cerebral venous sinus thrombosis, and may lead to stroke. Pregnant women with stroke show higher rates of pregnancy loss and experience serious pregnancy complications. We present the case of a 24-year-old pregnant woman with a transient ischemic attack (TIA) that developed after vaccination with the Moderna mRNA-1273 vaccine (at 37 2/7 wk).
CASE SUMMARY
TIA occurred 13 d following the coronavirus disease vaccination. At 39 1/7 wk of pregnancy, the patient presented with sudden onset of right eye blurred vision with headache, dizziness with nausea, right-hand weakness, anomia, and alexia. The symptoms lasted 3 h; TIA was diagnosed. Blood test results revealed elevated D-dimer, cholesterol, and triglyceride levels. Brain magnetic resonance imaging showed no acute hemorrhagic or ischemic stroke. At pregnancy 37 6/7 wk, she was admitted for cesarean delivery to reduce subsequent risk of stroke during labor. Body mass index on admission was 19.8 kg/m2. Magnetic resonance angiography and transesophageal echocardiography showed no abnormalities. The next day, a mature female baby weighing 2895 g and measuring 50 cm was delivered. Apgar scores were 8 and 9 in the first and fifth minutes. D-dimer levels decreased on postoperative day 4. After discharge, the autoimmune panel was within normal limits, including antinuclear and antiphospholipid antibodies.
CONCLUSION
TIA might be developed after the mRNA vaccines in pregnant women.
Core Tip: We reported the information of transient ischemic attack following coronavirus disease 2019 (COVID-19) mRNA vaccination in a pregnant woman. We also updated the information on vaccine-induced thrombosis caused by COVID-19 mRNA vaccination. Finally, since transient ischemic attack is a rare event associated with COVID-19 mRNA vaccination, vaccination should not be prohibited for pregnant women.
