Monkeypox and pregnancy: what do obstetricians need to know?

Khalil, Asma; Samara, Athina; O’Brien, Pat; Morris, Edward; Lees, Christoph; Ladhani, Shamez

doi:10.1002/uog.24968

Cited by 38 publications

(98 citation statements)

References 6 publications

(8 reference statements)

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“…In Central and West Africa, severe and even fulminant cases in children have been well described, 1 and are likely under‐reported due to difficulties with access to health‐care services and to monkeypox‐specific diagnostic tools. There are reports of fetal loss from monkeypox contracted in the first trimester, and advice has been published in the United Kingdom on the management of pregnant women with monkeypox or those who have been exposed to cases 5,6 . Smallpox vaccines provide some protection as post‐exposure prophylaxis against monkeypox, and some countries are instituting smallpox vaccination for people at occupational risk of exposure to monkeypox.…”

Section: Figmentioning

confidence: 99%

“…There are reports of fetal loss from monkeypox contracted in the first trimester, and advice has been published in the United Kingdom on the management of pregnant women with monkeypox or those who have been exposed to cases. 5,6 Smallpox vaccines provide some protection as postexposure prophylaxis against monkeypox, and some countries are instituting smallpox vaccination for people at occupational risk of exposure to monkeypox. However, there are challenges with vaccine availability in many settings, with only replicationcompetent vaccines (which have a high number of potential adverse effects) available in some countries.…”

mentioning

confidence: 99%

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Monkeypox

Isaacs

2022

J Paediatrics Child Health

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Section: Figmentioning

confidence: 99%

mentioning

confidence: 99%

Monkeypox

Isaacs

2022

J Paediatrics Child Health

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“…Although most cases in current outbreaks have presented with mild disease symptoms, Monkeypox virus may cause severe disease in certain population groups as immunosuppressed persons, young children and pregnant women (Di Giulio and Eckburg, 2004). Even if there are few data linking pregnant women and the effects of human Monkeypox virus infection, there is evidence that viruses of the Orthopoxvirus genus are associated with an increased risk of maternal and perinatal morbidity and mortality (Dashraath et al, 2022; Khalil et al, 2022; Mbala et al, 2017). Understanding how virulence evolves after a virus jumps or adapts to a new host species is critical to the effective prevention and treatment of viral infections.…”

Section: Resultsmentioning

confidence: 99%

The emergence of new lineages of the Mpox virus could affect the 2022 outbreak

Costa

Guterres

Neves

et al. 2022

Preprint

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Human monkeypox is a contagious zoonotic viral disease caused by Monkeypox virus and is causing a current outbreak in various regions of the world, being already considered an epidemic and a global public health problem. From the sequenced monkeypox genomes of clades B.1, A.1.1 and A.2 available, we performed analyzes of 9 proteins considered important in the pathogenesis of the disease (A9L, A36R, A50L, B9R, B16L, C3L, C7L, C12L (SPI-1) and H5R) and 4 important proteins for the host's immune response (A27L, A33R, B5R and L1R). We identified four synonymous mutations and six amino acid changes, of which four are in conserved domains, such changes can alter the function of proteins. Furthermore, we did not find the C3L protein in monkeypox genomes from the 2022 outbreak, an important protein for disease pathogenicity. Our analyses suggest that lineage/clade A.2 may be suffering the different effects of various selective pressures than lineage/clade B.1. In conclusion, the mutations identified in the present study have not yet been associated with genetic alterations, significant changes in the transmission route, mean age, signs/symptoms at the clinical presentation, and their evolution could be detected. Therefore, further research in the field is needed since our findings need to be confirmed by new studies.

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“…18 Recent European and UK guidance issued for the diagnosis and management of suspected monkeypox in pregnant women include the potential utility of available antivirals, vaccinia immune globulin (VIG) and safety considerations of postexposure vaccination. 31,32 Although the optimal mode of delivery to minimise overall transmission is unclear, caesarean section is recommended if genital lesions are present. 32 Infants born to mothers with monkeypox infection during pregnancy should be monitored closely in a special care unit.…”

Section: Disease Spectrum In Children and The Peripartum Periodmentioning

confidence: 99%

Monkeypox: A clinical update for paediatricians

Huang

Howard‐Jones

Durrani

et al. 2022

J Paediatrics Child Health

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The global spread of human monkeypox disease, a zoonotic infection related to smallpox and endemic to West and Central Africa, presents serious challenges for health systems. As of July 2022, 14 533 cases have been reported world‐wide, leading to designation as a Public Health Emergency of International Concern. Monkeypox disease is spread from animals to humans through infected lesions or fluids; human–human transmission occurs through fomites, droplets or direct contact. Illness is usually self‐limiting, but severe disease can occur in specific groups ‐ particularly children, and people who are immunocompromised or pregnant. Clinical presentation may include fever, lymphadenopathy and skin rash, but the rash may occur without other symptoms. Complications can include secondary bacterial infection of skin lesions, vision loss from corneal involvement, pneumonia, sepsis and encephalitis. Diagnosis of monkeypox requires consideration of epidemiological, clinical and laboratory findings, with sensitive history‐taking, to elicit close contacts, critical. Supportive management is usually sufficient, but treatment options (where required) include antivirals and vaccinia immune globulin. A paucity of safety data for relevant antivirals may limit their use. There are two types of monkeypox vaccines: a replication‐competent vaccinia vaccine, the use of which is logistically and clinically complex, and a replication‐deficient modified vaccinia Ankara virus vaccine. Preparedness of health systems for addressing the current outbreak is constrained by historic underfunding for research, and compounded by stigma and discrimination against cases and affected communities. Key challenges in halting transmission include improving vaccine equity and countering discrimination against men who have sex with men to aid diagnosis and treatment.

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Monkeypox and pregnancy: what do obstetricians need to know?

Cited by 38 publications

References 6 publications

Monkeypox

Monkeypox

The emergence of new lineages of the Mpox virus could affect the 2022 outbreak

Monkeypox: A clinical update for paediatricians

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