Escobar Maria, Nieto Albaro J, Loaiza-Osorio Sara, Barona Juan S, Rosso Fernando
Emerg Infect Dis. 2017 Nov;23(11):1777-83. doi: 10.3201/eid2311.170480.
In 2015 in Colombia, 60 pregnant women were hospitalized with chikungunya virus infections confirmed by reverse transcription PCR. Nine of these women required admission to the intensive care unit because of sepsis with hypoperfusion and organ dysfunction; these women met the criteria for severe acute maternal morbidity. No deaths occurred. Fifteen women delivered during acute infection; some received tocolytics to delay delivery until after the febrile episode and prevent possible vertical transmission. As recommended by a pediatric neonatologist, 12 neonates were hospitalized to rule out vertical transmission; no clinical findings suggestive of neonatal chikungunya virus infection were observed. With 36 women (60%), follow-up was performed 1 year after acute viremia; 13 patients had arthralgia in >2 joints (a relapse of infection). Despite disease severity, pregnant women with chikungunya should be treated in high-complexity obstetric units to rule out adverse outcomes. These women should also be followed up to treat potential relapses.
2015年在哥伦比亚,60名孕妇因逆转录聚合酶链反应确诊感染基孔肯雅病毒而住院。其中9名妇女因伴有低灌注和器官功能障碍的败血症而需要入住重症监护病房;这些妇女符合严重急性孕产妇发病标准。无死亡病例。15名妇女在急性感染期间分娩;一些人接受了宫缩抑制剂以延迟分娩至发热期过后,并防止可能的垂直传播。按照儿科新生儿科医生的建议,12名新生儿住院以排除垂直传播;未观察到提示新生儿基孔肯雅病毒感染的临床症状。36名妇女(60%)在急性病毒血症1年后进行了随访;13名患者有两个以上关节的关节痛(感染复发)。尽管疾病严重,但感染基孔肯雅病毒的孕妇应在高复杂性产科病房接受治疗,以排除不良后果。这些妇女还应接受随访以治疗潜在的复发。