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妊娠期间的登革热:综述文章。

Dengue in pregnancy: Review article.

作者信息

Mulik Varsha, Dad Nimra, Buhmaid Sara

机构信息

Sidra Medicine, Education City, Al Luqta Street, Doha, Qatar.

Sidra Medicine, Education City, Al Luqta Street, Doha, Qatar.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2021 Jun;261:205-210. doi: 10.1016/j.ejogrb.2021.04.035. Epub 2021 Apr 30.

Abstract

Dengue is the most common viral mosquito- borne disease. It is a major public health problem, especially in tropical and sub-tropical areas worldwide. According to the World Health Organization (WHO), approximately 40% of the world's population (over 2.5 billion people) live in areas with high risk of contracting dengue infection. Adults of childbearing age and pregnant women are travelling more frequently to tropical areas. Therefore exposing themselves to specific arboviral infections such as dengue, which may impact ongoing and future pregnancies. Clinical manifestations of dengue are wide ranging from asymptomatic to needing intensive care in cases of hemorrhagic dengue fever. The effects of dengue during and on pregnancy are unclear, moreover there is a lack of a cohesive reference to inform women of reproductive age who live in or travel to endemic areas and are at risk of contracting dengue. Here we present review of literature specifically looking at etiology, pathogenesis, clinical manifestations, management of dengue in pregnancy as well as its effect on maternal health and fetal outcomes. There is clear evidence to suggest adverse maternal outcomes in women with symptomatic dengue in low resource countries. A high index of clinical suspicion and early referral to tertiary center will prevent maternal -fetal serious adverse events in endemic areas. This review will help Clinicians in advising as well as managing women who travel during pregnancy to endemic areas as well as clinicians based in endemic areas who are managing women with dengue in pregnancy.

摘要

登革热是最常见的病毒性蚊媒疾病。它是一个重大的公共卫生问题,尤其是在全球热带和亚热带地区。根据世界卫生组织(WHO)的数据,世界上约40%的人口(超过25亿人)生活在有感染登革热高风险的地区。育龄期成年人和孕妇前往热带地区的频率更高。因此,他们更容易感染特定的虫媒病毒,如登革热,这可能会影响当前及未来的妊娠。登革热的临床表现范围广泛,从无症状到出血性登革热需要重症监护。登革热在孕期及对妊娠的影响尚不清楚,此外,缺乏连贯的参考资料来告知生活在或前往流行地区且有感染登革热风险的育龄妇女。在此,我们对文献进行综述,特别关注登革热在孕期的病因、发病机制、临床表现、管理及其对孕产妇健康和胎儿结局的影响。有明确证据表明,在资源匮乏国家,有症状的登革热孕妇会出现不良孕产妇结局。高度的临床怀疑指数和尽早转诊至三级中心将预防流行地区母婴严重不良事件的发生。本综述将有助于临床医生为孕期前往流行地区的妇女提供建议并进行管理,也有助于在流行地区管理登革热孕妇的临床医生。

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