Spectrum of dengue morbidity in pregnancy and its impact on maternal and perinatal outcome


  • Anuradha G. Department of Obstetrics and Gynecology, St. John’s Medical College Hospital, Bangalore, Karnataka, India
  • Sandya M. R. Department of Obstetrics and Gynecology, St. John’s Medical College Hospital, Bangalore, Karnataka, India
  • Shirley George Department of Obstetrics and Gynecology, St. John’s Medical College Hospital, Bangalore, Karnataka, India




Dengue, Maternal outcome, Pregnancy, Perinatal outcome, Thrombocytopenia


Background: Dengue is a vector borne viral infection with seasonal outbreaks every year. The spectrum varies from just a febrile morbidity to the severe form of dengue shock syndrome (DSS). The objective of the present study was to study the influence of dengue fever on pregnancy and to analyze the maternal and perinatal outcome.

Methods: Thirty-six pregnant women beyond 28weeks of gestation who tested positive for dengue infection were retrospectively analyzed during a 5year study period (Jan 2014-Dec 2018). The study was conducted in the Department of OBGYN St John’s Medical College Hospital, Bangalore. Thirty-three of these patients delivered at St John’s and there were three postpartum referral cases. The necessary data was obtained by patient record review. The data was analyzed using SPSS and the results were expressed as Mean±SD and percentages.

Results: Out of 36 women analyzed the mean age was found to be 23.93±4.5 years. Majority were primigravidae (58.3%). The most common clinical manifestation was fever seen in 47.2%. Twenty five percent of patients had platelet count of <20,000 on admission. Overall 66% of the patients required transfusion. Nearly fifty three percent of the patients had vaginal delivery. There were 4 maternal mortalities (11.1%) and 2 perinatal mortalities (5.5%) both were still births in the present study.

Conclusions: Dengue infection in pregnancy was associated with increased maternal and perinatal morbidity as well as mortality. The severity of the infection has direct impact on the outcome. Hence early diagnosis and prompt management in a tertiary care centre, with multidisciplinary approach improves the outcome and minimizes the complications.


Bharaj P, Chahar HS, Pandey A, Diddi K, Dar L, Guleria R, Kabra SK, Broor S. Concurrent infections by all four dengue virus serotypes during an outbreak of dengue in 2006 in Delhi, India. Virol J. 2008;5(1):1.

Gibbons RV, Vaughn DW. Dengue: an escalating problem. BMJ. 2002;324(7353):1563-6.

World Health Organization. Dengue haemorrhagic fever: diagnosis, treatment, prevention and control, 1997.

Balmaseda A, Hammond SN, Pérez MA, Cuadra R, Solano S, Rocha J, et al. Short report: Assessment of the World Health Organization scheme for classification of dengue severity in Nicaragua. Am J Trop Med Hyg 2005;73(6):1059-62.

Phuong CX, Nhan NT, Kneen R, Thuy PT, Van Thien C, et al. Clinical diagnosis and assessment of severity of confirmed dengue infections in Vietnamese children: is the World Health Organization classification system helpful? Am J Trop Med Hyg. 2004;70(2):172-9.

World Health Organization, Special Programme for Research, Training in Tropical Diseases, World Health Organization. Department of Control of Neglected Tropical Diseases, World Health Organization. Epidemic, Pandemic Alert. Dengue: guidelines for diagnosis, treatment, prevention and control. World Health Organization; 2009.

Carroll ID, Toovey S, Van Gompel A. Dengue fever and pregnancy—a review and comment. Travel Med Infect Dis. 2007;5(3):183-8.

Maroun SL, Marliere RC, Barcellus RC, Barbosa CN, Ramos JR, Moreira ME. Case report: vertical dengue infection. J De Pediatria. 2008;84(6):556-9.

Malhotra N, Chanana C, Kumar S. Dengue infection in pregnancy. Int J Gynaecol Obstet. 2006;94(2):131-2.

Malavige GN, Velathanthiri VG, Wijewickrama ES, Fernando S, Jayaratne SD, Aaskov J, Seneviratne SL. Patterns of disease among adults hospitalized with dengue infections. J Asso Physician. 2006;99(5):299-305.

Waduge R, Malavige GN, Pradeepan M, Wijeyaratne CN, Fernando S, Seneviratne SL. Dengue infections during pregnancy: a case series from Sri Lanka and review of the literature. J Clinic Virol. 2006;37(1):27-33.

S. Kariyawasam and H. Senanayake. Dengue infections during pregnancy: case series from a tertiary care hospital in Sri Lanka. e J Infect Develop Countries 2010;4(11):767-75.

Basurko C, Carles G, Youssef M, Guindi WE. Maternal and foetal consequences of dengue fever during pregnancy. Europe J Obstet Gynecol Reproduct Biol. 2009;147(1):29-32.

Chitra TV, Panicker S. Maternal and fetal outcome of dengue fever in pregnancy. J Vector Borne Dis. 2011;48(4):210-4.

Malhotra N, Chinana C, Kumar S. Dengue infection in pregnancy. Int J Gynecol Obstet. 2006;94(2):131-2.

Ooi ET, Ganesananthan S, Anil R, Kwok FY, Sinniah M. Gastrointestinal manifestations of dengue infection in adults. Med J Malaysia. 2008;63(5):401-5.

Machain-Williams C, Raga E, Baak-Baak CM, Kiem S, Blitvich BJ, Ramos C. Maternal, Fetal, and Neonatal Outcomes in Pregnant Dengue Patients in Mexico. BioMed research international. 2018;2018.

Carles G, Talarmin A, Peneau CH, Bertsch M. Dengue fever and pregnancy. A study of 38 cases in French Guiana. J Gynecol, Obstet Reproduct Biol. 2000;29(8):758-62.

Sharma S, Jain S, Rajaram S. Spectrum of maternofetal outcomes during dengue infection in pregnancy: an insight. Infectious diseases in obstetrics and gynecology. 2016;2016.






Original Research Articles