Dengue Virus Infection in Early Gestation With Delivery of an Unaffected Fetus and No Vertical Transmission

  • Tsai H
  • Lin C
  • Hong N
  • et al.
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Abstract

Dengue fever is an infectious, tropical viral disease. There have been a number of epidemics in Taiwan during the last century [1]. In addition, dengue hemorrhagic fever (DHF) and even dengue shock fever have been reported in recent decades. Dengue infection may cause disease in neonates born to infected mothers, but the teratogenic and abortion effects of dengue infection on pregnant women and their fetuses, especially dur-ing early gestation, are unclear. Prenatal genetic coun-seling is, therefore, crucial. Here, we present a pregnant woman of 11 + weeks' gestation who suffered from DHF, but finally gave birth to an unaffected full-term baby. A 30-year-old, gravida 2, para 1, woman at 11 + weeks' gestation was sent to our emergency department with a 3-day history of intermittent high fever (> 39°C) and headache. Her previous obstetric history and prenatal care were uneventful. Her body temperature was 38.4°C, and the results of urine analysis were within normal limits. Her white blood cell count was 7,100/μL, and her platelet count was 245,000/μL (Figure). The cause of her fever remained undetermined after the initial workup. After triage, the patient was admitted to the infec-tion ward. She was also closely monitored for serial full blood counts and urea levels, and by liver function tests and fetal echographic screening. Three days later, she developed nausea, petechiae, severe thrombocytopenia, and leucopenia (Figure). Her body temperature rose to a maximum of 39.7°C, and her platelet count dropped to 25,000/μL on the sixth day after admission (Figure). Acute dengue virus infection was highly suspected based on the patient's reported recent mosquito bite history, and this was subsequently confirmed by serologic tests. She was provided with supportive care, and the fever gradually subsided. Her blood platelet count had in-creased to normal by the ninth day. Regular prenatal care was arranged after discharge at our obstetrics outpatient department. An uncomplicated pregnancy led to the delivery of a normal healthy male infant at 39 weeks' gestation. Delivery was by cesarean section owing to a breech presentation. Serologic testing for immunoglobulins, IgG and IgM, against dengue virus was negative in the neonate, although IgG was still detected in the mother after delivery. Dengue fever is a major public health concern in Taiwan and in other countries in Southeast Asia.

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Tsai, H.-C., Lin, C.-C., Hong, N.-S., Kuo, T.-N., Huang, Y.-Y., Lin, M. Y.-S., … Chen, S.-H. (2010). Dengue Virus Infection in Early Gestation With Delivery of an Unaffected Fetus and No Vertical Transmission. Taiwanese Journal of Obstetrics and Gynecology, 49(1), 112–114. https://doi.org/10.1016/s1028-4559(10)60023-x

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