DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20200576

Outcome of Dengue infection in pregnancy at a tertiary care hospital in India

Naimah Raza, Nitin P. Dhungat

Abstract


Background: Dengue is one of the most important mosquito-borne diseases in India. This study was done to study the course of dengue infection in pregnant women, its effects, foeto-maternal outcome, and associated complications.

Methods: Clinical, laboratory findings, and maternal/foetal outcome were collected from patients with confirmed dengue infections in pregnancy treated at a tertiary care hospital in India, during a 6-month period.

Results: A total 12 seropositive cases of dengue infection in pregnancy were diagnosed during the study period. Thrombocytopenia coupled with rising haematocrit were seen in all cases. Prophylactic platelet transfusion was not necessary in any of the cases without bleeding manifestation. Three patients developed severe dengue with some complication requiring extra measures, including a case of dengue encephalitis which responded to supportive treatment. One case of intra-uterine foetal demise and multi-organ failure leading to maternal death was seen. Perinatal outcomes of the other cases were satisfactory.

Conclusions: Dengue in pregnancy requires early diagnosis and treatment. A high index of clinical suspicion is essential in any pregnant woman with fever, especially in endemic areas. Further studies are necessary as evidence-based data in the management of dengue in pregnancy is inadequate.


Keywords


Dengue, Fever, Pregnancy, Thrombocytopenia

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References


Dengue/DHF situation in India: National Vector Borne Disease Control Programme (NVBDCP). Nvbdcp.gov.in. Available at: https://nvbdcp.gov.in/index4.php?lang=1&level=0&linkid=431&lid=3715. Accessed on 6th February 2020.

World Health Organization. Dengue: Guidelines for diagnosis, treatment, prevention and control. Geneva, Switzerland: World Health Organization; 2009. Available at: http://apps.who.int/iris/bitstream/10665/44188/1/9789241547871_eng.pdf. Accessed on 6th February 2020.

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

Chotigeat U, Kalayanarooj S, Nisalak A. Vertical transmission of dengue infection in Thai infants: two case reports. J Med Assoc Thai. 2003;86(SUPP/3):628-32.

Chye JK, Lim CT, Ng KB, Lim JM, George R, Lam SK. Vertical transmission of dengue. Clin Infect Dis. 1997;25(6):1374-7.

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 Clin Virol. 2006;37:27-33.

Rosado Leon R, Munoz Rodriguez MR, Soler Huerta E, Parissi Crivelli A, Mendez Machado GF. Dengue fever during pregnancy. Cases Report. Ginecol Obstet Mex. 2007;75:687-90.

Phongsamart W, Yoksan S, Vanaprapa N, Chokephaibulkit K. Dengue virus infection in late pregnancy and transmission to the infants. Pediatr Infect Dis J. 2008;27:500-4.

Singh N, Sharma KA, Dadhwal V, Mittal S, Selvi AS. A successful management of dengue fever in pregnancy: report of two cases. Indian J Med Microbiol. 2008;26:377-80.

Basurko C, Carles G, Youssef M, Guindi WE. Maternal and foetal consequences of dengue fever during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2008;147:29-32.

Adam I, Jumaa AM, Elbashir HM, Karsany MS. Maternal and perinatal outcomes of dengue in Port Sudan, Eastern Sudan. Virol J. 2010;7(1):153.

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

Agrawal P, Garg R, Srivastava S, Verma U, Rani R. Pregnancy outcome in women with dengue infection in Northern India. Indian J Clin Pract. 2014;24(11):1053-6.

Malavige GN, Velathanthiri VG, Wijewickrama ES, Fernando S, Jayaratne SD, Aaskov J, et al. Patterns of disease among adults hospitalized with dengue infections. QJM. 2006;99:299-305.

Iyngkaran N, Yadav M, Sinniah M. Augmented inflammatory cytokines in primary dengue infection progressing to shock. Singapore Med J. 1995;36:218-21.

Soundravally R, Hoti SL, Patil SA, Cleetus CC, Zachariah B, Kadhiravan T, et al. Association between proinflammatory cytokines and lipid peroxidation in patients with severe dengue disease around defervescence. Int J Infect Dis. 2014;18:68-72.

Halstead SB. Dengue antibody-dependent enhancement: knowns and unknowns. Microbiol Spectr. 2014;2(6):249-71.

Sa-ngasang A, Wibulwattanakij S, Chanama S, Orapinpatipat A, Anuegoonpipat A, Anantapreecha S, et al. Evaluation of RT-PCR as a tool for diagnosis of secondary dengue virus infection. Jpn J Infect Dis. 2003;56:205-9.