The monkeypox variant circulating in Africa has highlighted the high possibility of infection of pregnant women and the risk to the fetus, be able to lose the baby. For this reason, a group of pediatricians and infectious disease specialists from Singapore, the United States, France and Switzerland have designed a actuation algorithm to deal with possible infections of the current variant of monkeypox.
“Doctors should keepr a high index of suspicion for monkeypox virus in any pregnant woman who presents lymphadenopathy and vesiculopustular rash, including localized rash in the genital or perianal areaalthough there are no apparent epidemiological links“, warn the authors of the article published in the journal The Lancet.
In this sense, specialists point out that the monkeypox infection (MPXV) or common smallpox assumes “a high risk of serious congenital infection, pregnancy loss and morbidity and maternal mortality”. Additionally, they note that genomic sequencing data suggests that the West African monkeypox virus clade is responsible for the current outbreak and although it is associated with milder disease and higher mortality lower in non-pregnant people The effects of this clade on pregnancy are unknown.
How to diagnose monkeypox in pregnant women?
According to the algorithm designed by international specialists, the diagnosis can be confirmed by real-time PCR nucleic acid amplification tests or conventional from vesicles or genital lesions.
Additionally, they recommend eliminate other diseases first such as chickenpox, herpes simplex, and syphilis, as they can resemble monkeypox during pregnancy. “In case of maternal infection with monkeypox virus, a ultrasound fetal monitoring and further treatment should be based on the presence of ultrasound abnormalities such as fetal hepatomegaly or dropsy,” the doctors explain.
The elimination of the virus can also be done naturally: “It is likely that the virus is excreted in the amniotic fluid if the fetal kidneys produce enough urine, that is, after 18 to 21 weeks of gestation”. As for the time of part, experts recommend assess the viral load in the blood of the umbilical cord and placenta, in addition to performing real-time PCR analysis of the samples obtained from the newborn.
Previous cases of complications due to infection
The cases that alerted the scientific community occurred in four pregnant women from the Democratic Republic of the Congo who have been infected with the monkeypox virus, although this is probably the Central African clade of the virus.
Certain events that occurred between 2007 and 2011 and resulted in two early miscarriages, nail baby lost at 18 weeks of pregnancy and delivery of a stillborn baby. “The fetus had a generalized rash and monkeypox virus DNA was detected in fetal tissue, umbilical cord and placenta, confirming vertical transmission of monkeypox virus,” the researchers explain. .
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