Document Detail


Dengue infections during pregnancy: a case series from Sri Lanka and review of the literature.
MedLine Citation:
PMID:  16843056     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dengue is a major public health problem in several countries. Few reports document presentations and outcomes of dengue during pregnancy. In many endemic countries as the average age of getting dengue infections is shifting upwards, dengue in pregnancy is likely to be encountered more frequently. Patterns of dengue in patients from different regions are needed if we are to draft evidence based management guidelines. OBJECTIVES: To document clinical and laboratory findings in a cohort of hospitalised patients with dengue during pregnancy in Sri Lanka and compare their presentation and outcomes with previously published cases. STUDY DESIGN: Clinical, laboratory, maternal and fetal outcomes and demographic information were collected from patients with confirmed dengue infections during pregnancy treated in a Maternity Hospital in Sri Lanka from 1 January 2000 to 30 June 2004. The Medline database was searched to identify reports relating to dengue infection during pregnancy since 1965. RESULTS: Twenty-six patients [mean (S.D.) age: 29 (4.2) years] were studied. One (3.8%), 2 (7.7%) and 20 (77%) presented in the first, second and third trimesters of pregnancy, and 3 (11.5%) in the immediate post-partum period. Seventeen (65.3%) had primary and nine (34.7%) secondary dengue infections. Ten (38.5%) had DF, 6 (23.1%): DHF grade I and 10 (38.5%): DHF grade II. Five (19.2%) and three (11.5%) patients who first presented with cough/breathlessness or vaginal bleeding, were initially managed as having a pulmonary embolism or a primary obstetric cause for their vaginal bleeding. Bradycardia was noted in three of the four patients who had a cardiac arrhythmia. Seven (26.9%) needed admission to an ICU. Raised AST and ALT levels were seen in 81.2% and 43.7% of 16 patients in whom liver function tests results were available. No fetal malformations were seen in any of the babies born. The single patient who developed DHF in the first trimester had an abortion while having acute symptoms of dengue. CONCLUSIONS: Awareness of clinical and laboratory manifestations of dengue in pregnancy should allow its early recognition and institution of appropriate treatment. Reports on dengue in pregnancy from different regions should allow more evidence-based guidelines to be formulated for optimum evaluation and care of such patients. Our data contributes towards this goal.
Authors:
Ranmali Waduge; G N Malavige; M Pradeepan; Chandrika N Wijeyaratne; Sirimali Fernando; Suranjith L Seneviratne
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Publication Detail:
Type:  Journal Article; Review     Date:  2006-07-13
Journal Detail:
Title:  Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology     Volume:  37     ISSN:  1386-6532     ISO Abbreviation:  J. Clin. Virol.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-28     Completed Date:  2006-12-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9815671     Medline TA:  J Clin Virol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  27-33     Citation Subset:  IM    
Affiliation:
Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Colombo, Sri Lanka.
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MeSH Terms
Descriptor/Qualifier:
Adult
Alanine Transaminase / blood
Arrhythmias, Cardiac
Bradycardia
Cough
Dengue* / diagnosis,  physiopathology
Dyspnea
Female
Hemorrhage
Humans
Inpatients
Liver Function Tests
Pregnancy
Pregnancy Complications, Infectious* / diagnosis,  physiopathology
Pregnancy Outcome
Sri Lanka
Treatment Outcome
Chemical
Reg. No./Substance:
EC 2.6.1.2/Alanine Transaminase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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