Monkeypox in pregnancy: virology, clinical presentation, and obstetric management

Dashraath, Pradip; Nielsen‐Saines, Karin; Rimoin, Anne W.; Mattar, Citra; Panchaud, Alice; Baud, David

doi:10.1016/j.ajog.2022.08.017

Cited by 31 publications

(51 citation statements)

References 62 publications

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“…The virus's genetics comprise two viral clades: the “Congo Basin” clade or the MPXV clade I, and the “West African” clade, or the MPXV clade IIa and IIb. The current outbreak is mainly comprised of the clade II monkeypox variants, which cause less severe symptoms than their counterpart 3 . Regrettably, pregnancy already places women at a higher susceptibility rate given the physiologic alteration in their immune system 7 and in turn may incur worse effects on the fetus 8,9 .…”

Section: Epidemiology and Etiologymentioning

confidence: 99%

“…This may lead to an underestimation of the true incidence. Still, it must be noted that pregnant women are at higher risk for monkeypox infection for two reasons 3 . First, this could be due to the discontinuation of smallpox vaccination and subsequent waning of the immunity conferred by the pox virus vaccine and fewer travel restrictions after the COVID‐19 pandemic 10 .…”

Section: Epidemiology and Etiologymentioning

confidence: 99%

“…First, this could be due to the discontinuation of smallpox vaccination and subsequent waning of the immunity conferred by the pox virus vaccine and fewer travel restrictions after the COVID‐19 pandemic 10 . Second, the shift of the immunity from T helper type 1 to T helper type 2 in pregnant women makes them more susceptible to viral illnesses than non‐pregnant women 3 . Similar to the other emerging infections, vertical transmission does occur, but data are scarce concerning the risk of transmission during breastfeeding.…”

Section: Epidemiology and Etiologymentioning

confidence: 99%

“…Human‐to‐human transmission can occur directly through skin lesions or respiratory droplets of infected humans or animals or indirectly through contaminated materials 2 . Also, transmission can occur through close physical contact (vaginal, oral, or anal sex) 3 . The basic reproduction number, or R0, of monkeypox is around 0.8, but that increases to more than 1 among men who have sex with men.…”

Section: Introductionmentioning

confidence: 99%

“…Most of them were from European regions, but the Western Pacific region, America, and the Eastern Mediterranean region also reported cases of monkeypox infection. Due to the high person‐to‐person transmission rate, monkeypox was considered a public health emergency on July 23, 2022 3 …”

Section: Introductionmentioning

confidence: 99%

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A review of monkeypox infection during pregnancy

Farah

Nasr

Ramadan

et al. 2022

Intl J Gynecology & Obste

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The present study aimed to review monkeypox infection during pregnancy: its epidemiology and etiology, transmission, clinical manifestations and complications, diagnosis, management, antenatal testing and delivery, prevention, awareness, and recommendations. Monkeypox can spread via vertical transmission. The usual clinical symptoms include fever, rash (vesicles, crust), new genital lesions, or sore throat. It is only recommended to use cidofovir in pregnant patients when they are severely infected with monkeypox. All woman who are at high risk of exposure for monkeypox need to be vaccinated with the smallpox vaccine regardless of their pregnancy status. Monitoring includes regular non‐stress test monitoring in addition to ultrasound performed at various stages of pregnancy. High index of suspicion, informed physicians, reporting of cases, and support of research are all needed for the management of monkeypox infection during pregnancy.

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Section: Epidemiology and Etiologymentioning

confidence: 99%

Section: Epidemiology and Etiologymentioning

confidence: 99%

Section: Epidemiology and Etiologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A review of monkeypox infection during pregnancy

Farah

Nasr

Ramadan

et al. 2022

Intl J Gynecology & Obste

View full text Add to dashboard Cite

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Mpox in pregnancy: Management, risks and challenges in Africa and lessons from the COVID‐19 pandemic

Ubom

Oiwoh

Ajiboye

et al. 2023

Intl J Gynecology & Obste

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Data on mpox in pregnancy are currently limited. Historically, only 65 cases in pregnancy have been reported globally since mpox was discovered in 1958. This includes 59 cases in the current outbreak. Vertical transmission was confirmed in one patient. Pregnant women are at high risk of severe disease owing to immunological and hormonal changes that increase susceptibility to infections in pregnancy. African women appear to be at higher risk of mpox infection and adverse outcomes in pregnancy for epidemiological and immunologic reasons, in addition to the background high rates of adverse feto‐maternal outcomes in the region. This risk is potentially heightened during the COVID‐19 pandemic due to the possibility of mpox virus exportation/importation as a result of the lifting of movement restrictions and trans‐border travels between countries affected by the current outbreak. Furthermore, coinfection with mpox and COVID‐19 in pregnancy is possible, and the clinical features of both conditions may overlap. Challenges of diagnosis and management of mpox in pregnancy in Africa include patients concealing their travel history from healthcare providers and absconding from/evading isolation after diagnosis, shortage of personal protective equipment and polymerase chain reaction testing facilities for diagnosis, vaccine hesitancy/resistance, and poor disease notification systems. There is a need for local, regional and global support to strengthen the capacity of African countries to address these challenges and potentially reduce the disease burden among pregnant women in the continent.

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