SOGC Committee Opinion on the Management of a Pregnant Woman Exposed to or Infected With Ebola Virus Disease in Canada

Abstract

Objective: To review the evidence and provide recommendations on the general management of a pregnant woman exposed to or infected with Ebola virus disease (EVD). Outcomes: Outcomes evaluated include general principles of approach and specific aspects of management of EVD relevant to pregnancy. Evidence: Published literature was retrieved through searches of Medline, EMBASE, and CINAHL in October 2014 using appropriate controlled vocabulary and key words (Ebola and pregnancy; hemorrhagic fever and pregnancy). Results were restricted to systematic reviews, randomized control trials/ controlled clinical trials, and observational studies published in English. Searches were updated and incorporated in the guideline to November 7, 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, and national and international medical specialty societies. Values: The quality of evidence in this document was rated using the criteria described in Report of the Canadian Task Force on Preventive Health Care (Table 1). Conclusion: Individuals incubating EVD but who do not yet have symptoms are not infectious. The chance of a pregnant woman presenting with EVD in Canada is minimal, as are the chances of her infecting others if reasonable precautions are in place. Evidence of maternal-fetal transmission is limited and anecdotal.