Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
Arch Gynecol Obstet. 2021 Jul;304(1):91-100. doi: 10.1007/s00404-020-05930-7. Epub 2021 Jan 2.
The primary objective of the study was to assess maternal and fetal outcomes of pregnancies affected with dengue fever.
This was a prospective, observational and descriptive study carried out over a period of 1 year. 216 pregnant women with fever were screened. Of these, 44 women tested positive for dengue (non-structural protein antigen 1 or dengue IgM antibodies in the sera). The clinical and laboratory characteristics of women with dengue were recorded. Maternal outcomes, pregnancy outcomes and fetal outcomes were studied.
Mean period of gestation was 31.89 ± 7.31 weeks. Thrombocytopenia was seen in 23 (52.3%) women. Of 40 women, 10 (25%) developed post-partum haemorrhage. The incidence of maternal systemic complications was high: eight (18.2%) women developed acute kidney injury and two (4.5%) required haemodialysis support; eight (18.2%) women developed ARDS and seven (15.9%) women required ventilatory support; four (9.1%) women developed acute liver failure. 18 (40.9%) women had evidence of shock. Seven (15.9%) women died and another seven (15.9%) were classified as WHO maternal near-miss cases. Two (4.5%) pregnancies suffered from miscarriages, four (9%) from still births and two (4.5%) from neonatal deaths. Preterm babies were delivered in 15 (34.1%) and low birth weight babies in 13 (29.5%).
Dengue in pregnancy adversely affects maternal and fetal outcomes with high maternal mortality of 15.9%. Prematurity and postpartum haemorrhage are significant risks to mother and baby. Vector control strategies should be implemented with vigour in affected areas.
本研究的主要目的是评估患有登革热的孕妇的母婴结局。
这是一项为期 1 年的前瞻性、观察性和描述性研究。对 216 例发热孕妇进行筛查。其中，44 例血清中非结构蛋白 1 或登革 IgM 抗体阳性的孕妇确诊为登革热。记录了患有登革热的孕妇的临床和实验室特征。研究了母婴结局和胎儿结局。
平均孕周为 31.89±7.31 周。23 例（52.3%）孕妇出现血小板减少。40 例中有 10 例（25%）发生产后出血。母体全身并发症发生率较高：8 例（18.2%）发生急性肾损伤，2 例（4.5%）需要血液透析支持；8 例（18.2%）发生急性呼吸窘迫综合征，7 例（15.9%）需要通气支持；4 例（9.1%）发生急性肝衰竭。18 例（40.9%）孕妇有休克证据。7 例（15.9%）孕妇死亡，另外 7 例（15.9%）为世界卫生组织产妇接近死亡病例。2 例（4.5%）妊娠流产，4 例（9%）死产，2 例（4.5%）新生儿死亡。15 例（34.1%）早产，13 例（29.5%）低出生体重儿。
妊娠合并登革热对母婴结局有不良影响，产妇死亡率高达 15.9%。早产和产后出血是母婴的重大风险。应在受影响地区大力实施病媒控制策略。
