Transient ischemic attack after mRNA-based COVID-19 vaccination during pregnancy: A case report

Area of Science:

• Neurology
• Obstetrics & Gynecology
• Vaccinology

Background:

• Thrombocytopenia with thrombosis syndrome (TTS) has been associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines.
• TTS can manifest as thrombosis, particularly cerebral venous sinus thrombosis, potentially leading to stroke.
• Stroke in pregnant women is linked to increased pregnancy loss and complications.

Observation:

• A 24-year-old pregnant woman developed a transient ischemic attack (TIA) 13 days post-Moderna mRNA-1273 vaccination.
• Symptoms included blurred vision, headache, dizziness, nausea, right-hand weakness, anomia, and alexia, lasting 3 hours.
• Elevated D-dimer, cholesterol, and triglyceride levels were noted; brain imaging showed no acute stroke.

Findings:

• The patient underwent cesarean delivery at 37 6/7 weeks gestation due to stroke risk.
• Post-delivery, D-dimer levels decreased, and autoimmune panels were within normal limits.
• The newborn was delivered healthy with normal Apgar scores.

Implications:

• This case suggests a potential association between mRNA COVID-19 vaccination and TIA in pregnant women.
• Further research is warranted to understand the risks and mechanisms of TTS in this population.
• Close monitoring and risk-benefit assessment are crucial for vaccinating pregnant women.