A case report of dengue haemorrhagic fever during the peripartum period: challenges in management and a case of vertical dengue transmission

Bopeththa, B. V. K. M.; Hemapriya, S.; Niranga, K. K. Gayan; Kotigala, Danushka S. K.

doi:10.1186/s12879-018-3352-x

Cited by 13 publications

(8 citation statements)

References 5 publications

(8 reference statements)

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“…The evidence of mosquito bite was ruled out since the mother and neonate were cared for in the ICU with containment from pathogens and germs, including mosquito. The onset of fever within 7 days of onset also supported the diagnosis of vertical transmission, as also observed in other case reports (Phupong, 2001;Bopeththa et al, 2018).…”

Section: Discussionsupporting

confidence: 87%

Clinical features and virological confirmation of perinatal dengue infection in Jambi, Indonesia: A case report

Haryanto¹,

Yohan

Santoso

et al. 2019

International Journal of Infectious Diseases

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The hyper-endemicity of dengue in Indonesia poses a significant threat of dengue virus (DENV) vertical transmission during pregnancy. A 29-year-old female at 38 weeks of pregnancy presented to hospital with acute fever and later confirmed with DENV infection. Due to signs of fetal distress, the neonate was delivered by emergency caesarean section. The mother developed a dengue critical phase post-caesarean with excessive bleeding and required blood transfusion. During the 6th day of life, the neonate was diagnosed and later confirmed with dengue. Next-generation sequencing of DENV RNA isolated directly from sera of both mother and neonate revealed identical DENV-2 whole-genome sequences. Plaque reduction neutralization test (PRNT) detected anti-dengue antibodies in both mother and neonate. Altogether, our data confirmed the occurrence of vertical transmission. Dengue vertical transmission during pregnancy may lead to severe manifestation, hence early diagnosis, close monitoring, and prompt intervention are critical.

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Section: Discussionsupporting

confidence: 87%

Clinical features and virological confirmation of perinatal dengue infection in Jambi, Indonesia: A case report

Haryanto¹,

Yohan

Santoso

et al. 2019

International Journal of Infectious Diseases

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“…On the other hand, in cases of maternal shock, delivery might significantly improve maternal resuscitation, reducing the oxygen requirement and improving venous return. Such an approach was anticipated by a team in Sri Lanka in a case of a woman with haemorrhagic dengue fever at 38 WG who delivered by caesarean section as soon as warning signs presented 57 . At the time of the section, hematocrit remained within normal parameters and platelets were 72 G/L, allowing for spinal anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

Dengue, Zika and chikungunya during pregnancy: pre- and post-travel advice and clinical management

Vouga

Chiu

Pomar

et al. 2019

Journal of Travel Medicine

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Rationale for review Young adults of childbearing age and pregnant women are travelling more frequently to tropical areas, exposing them to specific arboviral infections such as dengue, zika and chikungunya viruses, which may impact ongoing and future pregnancies. In this narrative review, we analyse their potential consequences on pregnancy outcomes and discuss current travel recommendations. Main findings Dengue virus may be associated with severe maternal complications, particularly post-partum haemorrhage. Its association with adverse fetal outcomes remains unclear, but prematurity, growth retardation and stillbirths may occur, particularly in cases of severe maternal infection. Zika virus is a teratogenic infectious agent associated with severe brain lesions, with similar risks to other well-known TORCH pathogens. Implications of chikungunya virus in pregnancy are mostly related to intrapartum transmission that may be associated with severe neonatal infections and long-term morbidity. Travel recommendations Few agencies provide specific travel recommendations for travelling pregnant patients or couples trying to conceive and discrepancies exist, particularly regarding Zika virus prevention. The risks significantly depend on epidemiological factors that may be difficult to predict. Prevention relies principally on mosquito control measures. Couples trying to conceive and pregnant women should receive adequate information about the potential risks. It seems reasonable to advise pregnant women to avoid unnecessary travel to Aedes spp. endemic regions. The current rationale to avoid travel and delay conception is debatable in the absence of any epidemic. Post-travel laboratory testing should be reserved for symptomatic patients.

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“…In our serial cases, no vertical transmission was found, similar to an Indian study in eight pregnancies [ 22 ]. It is possible that the vertical transmission rate might be dependent on the severity of maternal dengue [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Case Series of Dengue Fever in Peripartum Period: Maternal and Foetal Outcome

Saroyo

Sungkar

Irwinda

et al. 2020

Infectious Disease Reports

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Introduction: Dengue fever is a major public health problem in tropical and subtropical areas. There are not many studies concerning the complications of dengue fever in pregnancy. We present four serial cases of dengue fever in pregnancy. Case illustration: Three of four cases were delivered by caesarean section; two of them died during post-caesarean care. All cases had the lowest platelet level below 50,000/µL and were given platelet transfusion during and after delivery; they also showed abnormal liver function tests. For foetal outcome, none tested positive for dengue. Discussion: Complication of dengue infection depends on a combination of host and viral virulence. Regardless of prophylactic platelet transfusion, some studies revealed clinical bleeding in patients with dengue infection due to an intricate effect on the haemostatic system. The adverse foetal outcome may contribute because of placental circulation caused by endothelial damage with increased vascular permeability leading to plasma leakage. There is no national guideline for dengue fever in pregnancy. Conclusions: The management of dengue fever in pregnancy at the tertiary hospital is still suboptimal. Dengue fever around peripartum presents a higher risk of morbidity and mortality for the mother and therefore needs a multidiscipline team approach.

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A case report of dengue haemorrhagic fever during the peripartum period: challenges in management and a case of vertical dengue transmission

Cited by 13 publications

References 5 publications

Clinical features and virological confirmation of perinatal dengue infection in Jambi, Indonesia: A case report

Clinical features and virological confirmation of perinatal dengue infection in Jambi, Indonesia: A case report

Dengue, Zika and chikungunya during pregnancy: pre- and post-travel advice and clinical management

Case Series of Dengue Fever in Peripartum Period: Maternal and Foetal Outcome

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