Dengue during pregnancy – Symptoms & Treatment
If you live in Southeast Asia or the Western Pacific where mosquitoes are plentiful, you should be aware of dengue – a potentially fatal infection.
What is dengue?
Dengue is one of the widely known mosquito-borne viral infections caused by the dengue virus. It is transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Each episode of infection will provide life-long immunity to the serotype if you suffer from a second infection, you are at high risk for severe dengue due to antibody-dependent enhancement. Pregnant mothers can pass the virus to the fetus during pregnancy or around the time of delivery. It may result in harmful effects to the fetus including low birth weight, premature baby or even death.
According to the World Health Organisation (WHO), dengue is a viral infection which is spread when an infected female Aedes bites. Sometimes, severe dengue cases can result in internal bleeding, shock and even fatality. If you suffered and recovered from a dengue infection before, you will be more likely to develop severe dengue the second time. Pregnant mothers and babies are also at a higher risk of developing severe dengue.
How Does Dengue Affect My Pregnancy?
An early diagnosis of dengue infection during pregnancy is usually difficult to use for physiological changes of pregnancy. Dengue infection during pregnancy, the percentage of both mothers and the newborn for the risk of bleeding is higher compared to non-pregnant women. The mortality rate is about three times higher.
Maternal complications of Dengue Infection
a. If you are infected with Dengue virus but progress to spontaneous vaginal birth, you do not have additional risk of bad outcomes
b. Abortion is associated with first trimester infection
c. Preterm delivery is commonly associated with third trimester infection
d. Infection around labour time is associated with worse outcomes contributed by massive bleeding
Fetal complications of Dengue Infection
a. The virus can be transmitted from the infected symptomatic mother to the fetus
b. Preterm delivery, fetal death, low birth weight or miscarriage
While past studies have found a low risk of spreading the infection to your baby, being infected with dengue will complicate your pregnancy.
If you suffer from dengue during pregnancy, you will be at risk of preterm delivery, babies with low birth weight, abnormal growth of your baby, pre-eclampsia, and in the worst-case scenario: the death of the baby. If you are infected by dengue during the last trimester, there is also a possibility of you spreading the infection to the baby, which can be fatal.
The number of days between when you are infected with when you might develop symptoms for dengue infection is 4-7 days. You may be infected but show no symptoms or you may have a spectrum of illnesses ranging from mild fever to severe, with or without blood leakage and organ impairment. Dengue infection is followed by 3 phases, including:
Febrile (fever) phase
High fever accompanied by rash, body ache, vomiting and headache.
Abdominal pain, persistent vomiting and/or diarrhoea, confused, mucosal bleed and restlessness.
Patient’s condition improves and recovers spontaneously.
Dengue has flu-like symptoms, and can only be confirmed after a blood test. Hence, it is easily dismissed as a common flu. However, do take note of these symptoms and consult your doctor if you have similar symptoms.
Common dengue symptoms include high fever (38º C or higher) for more than three days, severe headache, eye pain, usually behind the eyes which worsens when moving your eyes, muscle and joint pains, rashes appearing over your chest or upper limbs, and nausea or vomiting.
If you suspect that you have dengue, do consult your doctor immediately, to help prevent complications.
After you are diagnosed with dengue, you will be immediately started on an appropriate fluid therapy (oral or intravenous).
For mild dengue fever, doctors will advise you to drink plenty of fluids, like water, fresh juices, and coconut water, to prevent you from being dehydrated after vomiting. The doctor will reduce the temperature spikes with antipyretic drugs such as Paracetamol. It is important to avoid Aspirin and Ibuprofen, as these medications will increase the risk of bleeding.
Severe dengue can be life-threatening, you will have to be hospitalized for further monitoring of your temperature, blood pressure and platelet count. Therefore, blood and blood products should be transfused as indicated. Spontaneous vaginal birth is the preferred mode of delivery. Instrumental delivery should be avoided where possible. If you are opted for instrumental or operative delivery, the doctor will make sure blood and blood products that are compatible with your body are available.
There is currently no specific medication to treat dengue. Dengue infection is treated similarly to all individuals. It is important to let your doctor know that you are pregnant so that they can treat your dengue infection without harming you and your baby. Early detection for dengue infection is important, as sufficient medical care after detection can reduce the chances of fatality to less than 1%.