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Dengue fever is caused by one of four viruses: Dengue 1, Dengue 2, Dengue 3, and Dengue 4. It is transmitted to humans via mosquito bites from infected Aedes species
Dengue fever is caused by one of four viruses: Dengue 1, Dengue 2, Dengue 3, and Dengue 4. It is transmitted to humans via mosquito bites from infected Aedes species (Aedes aegypti or Aedes albopictus) and is a diseasefound in more than 100 nations throughout the world.Dengue fever affects around 3 billion people and is a common cause of sickness in pregnancy. It was estimated that more than 22,000 people die each year from severe dengue viral infection1.
From mother to child
A dengue-infected pregnant mother can transmit the virus to her fetus throughout pregnancy or shortly after birth. One documented case of dengue transmission through breast milk to date2.
Symptoms, treatment, and outcomes
Dengue fever symptoms, treatment, and outcomes in pregnant women are comparable to those seen in non-pregnant women. Due to some of the overlapping clinical and/or laboratory findings with the more well-known pregnancy disorders, misdiagnosis or delayed diagnosis occurs. Common symptom includes fever, rash, vomiting, headache etc. In case of severe dengue infection shock, thrombocytopenia, hemorrhage, hypovolemia, encephalopathy, oligohydramniosetc could be found3. Further retroocular pain, itching in palms and change in taste is a common symptom of dengue infection.
Preterm birth, low birth weight, and caesarean births are all risk factors for dengue4.
Significant impact of dengue during parturition:
Severe bleeding may complicate delivery and/or surgical procedures performed on pregnant patients with dengue during the critical phase, i.e. the period coinciding with significant thrombocytopenia with or without plausibility.
Challenges in recognition of dengue disease and plasma leakage in pregnancy
Vomiting which is one of the warning signs may be taken as hyperemesis of pregnancy. Lower baseline BP, Baseline Tachycardia, and Lower baseline HCT attributed to physiological rise in blood volume.
Because of the danger of vertical transmission, newborns with mothers who had dengue fever just before or during delivery should be thoroughly observed in the hospital following birth. When protective maternal antibodies are not produced in time, serious foetal or neonatal dengue disease and death can occur during or shortly after birth5.
WHO Lab Criteria for Dengue
CF + Supportive Serology: Acute HI titre> 1280, comparable IgG ELISA or +ve IgM or occurrence at same location & time as other confirmed cases
Management of dengue fever in Pregnancy7
Suspect Dengue in pregnant patients coming with Fever.
All pregnant patients with suspected dengue are advised admission forclose monitoring. without warning signs (Group A)
Labs: Daily CBC, other investigations if necessary.
Warning sign (Group B)
With shock (GroupC)
Rise of WBC count followed by rise of platelet count, stabilization of HCT marks convalescent phase. Watch for signs of fluid overload – cough, wheeze, tachypnea etc.
Prevention of dengue infection
|Dr. Rabindra Kr. Yadav