Is it time to start COVID-19 vaccination in pregnant women?

HIGHLIGHTS1. Pregnant women infected with COVID-19 have a higher risk of maternal fetal mortality and morbidity.2. The available evidence shows a safety profile in all types of COVID-19 vaccines in pregnancy.3. Vaccination in pregnant women will decrease pregnancy complications, adverse pregnancy outcomes and maternal death risk.4. The benefit of COVID vaccination exceeds the potential risk in pregnant women.5. Pregnant women are strongly recommended to receive COVID vaccine. COVID-19 pandemic has been lasting for years and pregnant women encounter an increased risk of mortality and morbidity. Until now vaccine COVID-19 has been developed and shows promising results. Unfortunately, pregnant women are consistently excluded from receiving a new vaccine. Because pregnant women are excluded from participating in a clinical trial of vaccines related to safety issues this exclusion cycle prevents pregnant women from receiving the vaccine that may benefit them. In this review article the author provides evidence and the reason why vaccination of pregnant women should be started in Indonesia at least in a clinical trial especially for health workers and women with comorbidities.

Successful management of a pregnant woman with COVID-19 and multiple severe complications.

We report a case of a 36-year-old gravida 2 para 1 woman at 38 weeks of gestation. A caesarean section was performed for severe pre-eclampsia, intrauterine growth restriction and oligohydramnios. The patient suffered postoperative bleeding, and exploratory laparotomy was performed. Uterine atonia, Couvelaire uterus and left adnexal haematoma were found, requiring a supracervical hysterectomy. As COVID-19 pneumonia and superimposed bacterial infection developed, the patient was mechanically ventilated in the intensive care unit. Remdesivir and meropenem were initially administered, but were changed to levofloxacin and ciprofloxacin following antibiotic sensitivity tests. Blood culture grew Enterococcus galinarum Meanwhile, bleeding of the incisional wound occurred, which was controlled by the cessation of heparin therapy and regular wound care. With intensive monitoring and multidisciplinary management, the patient's condition improved, and she was discharged from the hospital on day 25 from admission.