Dengue haemorrhagic fever in late pregnancy causing maternal and intrauterine foetal death – A case report
<p>Dengue during pregnancy carries a higher risk of maternal and foetal complications, either through haemodynamic instability from disruption of the placental perfusion or through vertical transmission to the foetus.</p><p>A previously healthy 29-year-old primigravidae with a POA...
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| Format: | Article |
| Language: | English |
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Sri Lankan Society for Microbiology
2019-04-01
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| Series: | Sri Lankan Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | https://sljid.sljol.info/articles/8215 |
| _version_ | 1818468406209282048 |
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| author | SA Gunawardena V Dias O Amarajeewa P Ellangage S Gunarathna P Gunaratne H Gunawardhana S Jayasuriya |
| author_facet | SA Gunawardena V Dias O Amarajeewa P Ellangage S Gunarathna P Gunaratne H Gunawardhana S Jayasuriya |
| author_sort | SA Gunawardena |
| collection | DOAJ |
| description | <p>Dengue during pregnancy carries a higher risk of maternal and foetal complications, either through haemodynamic instability from disruption of the placental perfusion or through vertical transmission to the foetus.</p><p>A previously healthy 29-year-old primigravidae with a POA of 34 weeks presented with one day fever to a tertiary hospital. NS 1 antigen for dengue was positive. She entered the critical phase the following day and her platelet count dropped to 3000/ml by day 3. Intra uterine death was diagnosed on day 4. She continuously deteriorated and died on day 7. At autopsy, gross bleeding manifestations were noted in the mother, along with bilateral pleural effusions, massive sub endocardial haemorrhages and an enlarged liver with sub capsular haemorrhages. The placenta was devoid of any haemorrhages or infarcts. Sub-aponeurotic and subarachnoid haemorrhages and 50ml of blood within the thoracic and peritoneal cavities were found in a mature female foetus with minimal signs of maceration. Laboratory confirmation of foetal dengue virus infection was not possible.</p><p>This is a rare case where fatal haemorrhagic manifestations were seen in both the mother and the foetus suggesting vertical transmission. The autopsy findings highlight the unpredictable haemodynamic changes in the uterine circulation which severely hinder dengue management during pregnancy. Dengue infection, especially in late pregnancy, can lead to unpredictable fatal outcomes. The potential benefit of performing an emergency caesarean in such cases should be further explored.</p> |
| first_indexed | 2024-04-13T21:11:49Z |
| format | Article |
| id | doaj.art-ee2b056f9b4e45789d5545c9cd94a18d |
| institution | Directory Open Access Journal |
| issn | 2012-8169 2448-9654 |
| language | English |
| last_indexed | 2024-04-13T21:11:49Z |
| publishDate | 2019-04-01 |
| publisher | Sri Lankan Society for Microbiology |
| record_format | Article |
| series | Sri Lankan Journal of Infectious Diseases |
| spelling | doaj.art-ee2b056f9b4e45789d5545c9cd94a18d2022-12-22T02:29:48ZengSri Lankan Society for MicrobiologySri Lankan Journal of Infectious Diseases2012-81692448-96542019-04-0191889410.4038/sljid.v9i1.82155810Dengue haemorrhagic fever in late pregnancy causing maternal and intrauterine foetal death – A case reportSA Gunawardena0V Dias1O Amarajeewa2P Ellangage3S Gunarathna4P Gunaratne5H Gunawardhana6S Jayasuriya7University of ColomboFaculty of Medicine, ColomboFaculty of Medicine, PeradeniyaFaculty of Medicine, University of ColomboFaculty of Medicine, University of ColomboFaculty of Medicine, University of ColomboFaculty of Medicine, Sri JayawardenapuraFaculty of Medicine, Sri Jayawardenapura<p>Dengue during pregnancy carries a higher risk of maternal and foetal complications, either through haemodynamic instability from disruption of the placental perfusion or through vertical transmission to the foetus.</p><p>A previously healthy 29-year-old primigravidae with a POA of 34 weeks presented with one day fever to a tertiary hospital. NS 1 antigen for dengue was positive. She entered the critical phase the following day and her platelet count dropped to 3000/ml by day 3. Intra uterine death was diagnosed on day 4. She continuously deteriorated and died on day 7. At autopsy, gross bleeding manifestations were noted in the mother, along with bilateral pleural effusions, massive sub endocardial haemorrhages and an enlarged liver with sub capsular haemorrhages. The placenta was devoid of any haemorrhages or infarcts. Sub-aponeurotic and subarachnoid haemorrhages and 50ml of blood within the thoracic and peritoneal cavities were found in a mature female foetus with minimal signs of maceration. Laboratory confirmation of foetal dengue virus infection was not possible.</p><p>This is a rare case where fatal haemorrhagic manifestations were seen in both the mother and the foetus suggesting vertical transmission. The autopsy findings highlight the unpredictable haemodynamic changes in the uterine circulation which severely hinder dengue management during pregnancy. Dengue infection, especially in late pregnancy, can lead to unpredictable fatal outcomes. The potential benefit of performing an emergency caesarean in such cases should be further explored.</p>https://sljid.sljol.info/articles/8215infectious diseases in pregnancy, vertical transmission, maternal mortality, tropical diseases |
| spellingShingle | SA Gunawardena V Dias O Amarajeewa P Ellangage S Gunarathna P Gunaratne H Gunawardhana S Jayasuriya Dengue haemorrhagic fever in late pregnancy causing maternal and intrauterine foetal death – A case report Sri Lankan Journal of Infectious Diseases infectious diseases in pregnancy, vertical transmission, maternal mortality, tropical diseases |
| title | Dengue haemorrhagic fever in late pregnancy causing maternal and intrauterine foetal death – A case report |
| title_full | Dengue haemorrhagic fever in late pregnancy causing maternal and intrauterine foetal death – A case report |
| title_fullStr | Dengue haemorrhagic fever in late pregnancy causing maternal and intrauterine foetal death – A case report |
| title_full_unstemmed | Dengue haemorrhagic fever in late pregnancy causing maternal and intrauterine foetal death – A case report |
| title_short | Dengue haemorrhagic fever in late pregnancy causing maternal and intrauterine foetal death – A case report |
| title_sort | dengue haemorrhagic fever in late pregnancy causing maternal and intrauterine foetal death a case report |
| topic | infectious diseases in pregnancy, vertical transmission, maternal mortality, tropical diseases |
| url | https://sljid.sljol.info/articles/8215 |
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