Emerg Infect Dis. 2019 Aug;25(8):1494-500. doi: 10.3201/eid2508.181299.
Lassa fever in pregnancy causes high rates of maternal and fetal death, but limited data are available to guide clinicians. We retrospectively studied 30 pregnant Lassa fever patients treated with early ribavirin therapy and a conservative obstetric approach at a teaching hospital in southern Nigeria during January 2009–March 2018. Eleven (36.7%) of 30 women died, and 20/31 (64.5%) pregnancies ended in fetal or perinatal loss. On initial evaluation, 17/30 (56.6%) women had a dead fetus; 10/17 (58.8%) of these patients died, compared with 1/13 (7.7%) of women with a live fetus. Extravaginal bleeding, convulsions, and oliguria each were independently associated with maternal and fetal or perinatal death, whereas seeking care in the third trimester was not. For women with a live fetus at initial evaluation, the positive outcomes observed contrast with previous reports, and they support a conservative approach to obstetric management of Lassa fever in pregnancy in Nigeria.
拉沙热孕妇的死亡率和胎儿死亡率都很高，但目前可用的指导临床医生的信息有限。我们回顾性研究了 2009 年 1 月至 2018 年 3 月在尼日利亚南部一所教学医院接受早期利巴韦林治疗和保守产科治疗的 30 例拉沙热孕妇。30 名女性中有 11 名（36.7%）死亡，31 例妊娠中有 20 例（64.5%）以胎儿或围产期丢失告终。在初始评估时，30 名女性中有 17 名（56.6%）死胎；在这 17 名死胎患者中，10 名（58.8%）死亡，而活胎患者中只有 1 名（7.7%）死亡。阴道外出血、抽搐和少尿均与母亲和胎儿或围产儿死亡独立相关，而在妊娠晚期寻求治疗则没有关系。对于初始评估时有活胎的女性，观察到的良好结局与之前的报告相反，支持对尼日利亚拉沙热孕妇采用保守的产科处理方法。
