Publication:

Maternal and fetal outcome of dengue fever during pregnancy

Background With increasing rate of adult dengue fever victims, the number of infected pregnant women has also increased. Dengue, during pregnancy may be associated with various complications, including maternal mortality, preterm delivery, fetal death, low birth weight, neonatal admissions, fetal anomalies, and miscarriage. Timely intervention can improve the maternal as well as fetal outcome. The aim of the study was to assess the clinical profile, maternal and fetal outcome of dengue fever during pregnancy.

Methods A prospective study was carried out, among the antenatal patients who were diagnosed with serologically confirmed dengue fever during a period of 18 months; at a Tertiary care Hospital in Government sector in Kerala, South India. Patients were included irrespective of period of gestation of contracting the disease and were followed up till delivery and all babies were followed up to six weeks post-partum.

Results Thrombocytopenia(<1.5L/mm3) was found in 86.3% patients, of which 2.7% patients had Platelet count below 20,000 cells/mm3 and 4.1% patients required platelet transfusion. Other complications observed were spontaneous abortions (5.5%); preterm birth (9.5%), oligohydramnios (8.2%) and antepartum hemorrhage (4.1%). Fetal distress and meconium stained amniotic fluid were observed in 7.6% and 16.7% patients respectively. Adverse fetal outcome observed were low birth weight (27.3%), prematurity (23%) and 28.7% of the babies required NICU admission.

Conclusions The gestational age at presentation of dengue fever appeared to be significant. Early onset or late onset in pregnancy appeared to have a bad prognosis. A high index of clinical suspicion is essential in any pregnant female with fever during epidemics especially in endemic areas like Kerala. Conservative medical and obstetrical management is the treatment of choice.