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

Abstract

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.

Atypical presentation of mpox in Irrua environs: a case report

“…This may also give an explanation to the possible community perception and associated health-seeking behavior in resource-poor settings where mpox is yet to be confirmed. More information on the transmission (typical, possible asymptomatic, and perinatal transmission), genomics, and various diagnostic challenges will strengthen surveillance and riskcommunication strategies that will ensure control and eradication of mpox [11,12,[20][21][22][23][24].…”

Monkeypox, abortion, and vertical transmission: A consideration in obstetrics

“…The avoidance of contact and safe sexual intercourse is a fundamental rule for disease prevention. [ 6 ] Although particular vaccines are currently available, they are not generally recommended. [ 7 ] Currently, WHO-approved vaccines are replicating (ACAM2000), low replicating (LC16m8), and nonreplicating (MVA-BN).…”