Clinical Study on Spectrum of Dengue Morbidity in Pregnancy and Its Impact

Abstract

Introduction: Dengue is a mosquito borne viral disease transmitted by Aedes. Dengue infection in pregnancy carries the risk of hemorrhage for both the mother and the newborn. In addition, there is a serious risk of premature birth and fetal death. In case of infection close to term, there is a risk of vertical transmission. Timely intervention can improve the maternal as well as fetal outcome. This study was aimed to assess the presentation, maternal and fetal outcome of dengue fever (DF) during pregnancy. Materials and methods: The study was carried out on 35 pregnant females diagnosed and serologically confirmed to have DF and who were admitted in Vydehi Institute of Medical Sciences and Research Centre. Patients were included irrespective of the period of gestation. Serological testing for dengue virus-specific antigen and antibody was done for the diagnosis. Proforma was designed accordingly and used to collect data. Informed written consent was obtained. Result: In the present study on 35 patients suffering with DF, they are presented as the following in each trimester: 9 patients in the first trimester, 8 of them in the second trimester, and maximum, i.e., 18 patients, in the third trimester. About 13 cases were diagnosed by the nonstructural protein 1 (NS1) antigen, 17 by the immunoglobulin M (IgM) antibody, and 5 by the immunoglobulin G (IgG) +IgM antibody. Only two cases were febrile at delivery, but there was no case of dengue in infants. Platelet transfusion was required in four patients who had platelet <30,000. Term delivery was in 19 (54%) patients, preterm in 6 (17%) patients, lost to follow up 5 (14%) patients, and abortions in 5 (15%) patients. Out of 25 deliveries, 13 (52%) of them were full term normal delivery (FTND), 12 (48%) were lower segment cesarean section (LSCS), and none were complicated by postpartum hemorrhage. No cases of neonatal transmission were noted. Conclusion: Dengue infection in pregnancies need multimodal approach and treatment for potential fetal and maternal complications. Early detection and appropriate fluid administration and monitoring can decrease the mortality and morbidity associated with dengue infection.