Dengue in pregnancy: an under-reported illness, with special reference to other existing co-infections

OBJECTIVE@#To keep the level of awareness high as far as incidence of dengue among pregnant women is concerned.@*METHODS@#A total of 300 blood samples of patients with fever in pregnancy were received in the Department of Microbiology to rule out dengue infection (January 2011 to December 2012). The samples were put up for presence of dengue IgM antibodies and NS1Ag by ELISA. The patients who turned out to be positive for dengue serology were retrospectively analysed with respect to patient's age, gestational age, clinical presentation, complications, platelet counts and maternal as well as foetal outcomes.@*RESULTS@#Out of 300 females tested, 22 (7.3%) were found positive for dengue infection during the said time period. Out of them 9 were positive for IgM antibodies against dengue and 10 were found to be positive for NS1Ag, while 3 were positive for both IgM antibody and NS1Ag. Five patients presented with dengue in first trimester, 9 in second trimester and 8 in third trimester. Two patients had coinfections. Patient with coinfection of dengue with malaria had intrauterine death of fetus at 37 weeks while the second one having dengue with typhoid had a preterm vaginal delivery at 35 weeks.@*CONCLUSIONS@#Establishing diagnosis of dengue infection in pregnancy is important for effective management by the obstetricians particularly the mode of delivery due to the potential risk of hemorrhage for both the mother and the newborn. Co-infections seen in endemic areas may be more common than usually reported.

Dengue in pregnancy: An under-reported illness, with special reference to other existing co-infections

Objective: To keep the level of awareness high as far as incidence of dengue among pregnant women is concerned. Methods: A total of 300 blood samples of patients with fever in pregnancy were received in the Department of Microbiology to rule out dengue infection (January 2011 to December 2012). The samples were put up for presence of dengue IgM antibodies and NS1Ag by ELISA. The patients who turned out to be positive for dengue serology were retrospectively analysed with respect to patient's age, gestational age, clinical presentation, complications, platelet counts and maternal as well as foetal outcomes. Results: Out of 300 females tested, 22 (7.3%) were found positive for dengue infection during the said time period. Out of them 9 were positive for IgM antibodies against dengue and 10 were found to be positive for NS1Ag, while 3 were positive for both IgM antibody and NS1Ag. Five patients presented with dengue in first trimester, 9 in second trimester and 8 in third trimester. Two patients had coinfections. Patient with coinfection of dengue with malaria had intrauterine death of fetus at 37 weeks while the second one having dengue with typhoid had a preterm vaginal delivery at 35 weeks. Conclusions: Establishing diagnosis of dengue infection in pregnancy is important for effective management by the obstetricians particularly the mode of delivery due to the potential risk of hemorrhage for both the mother and the newborn. Co-infections seen in endemic areas may be more common than usually reported.

Dengue in pregnancy：an under-reported illness, with special reference to other existing co-infections

Objective:To keep the level of awareness high as far as incidence of dengue among pregnant women is concerned.Methods:A total of 300 blood samples of patients with fever in pregnancy were received in the Department of Microbiology to rule out dengue infection (January 2011 to December 2012). The samples were put up for presence of dengue IgM antibodies and NS1Ag by ELISA. The patients who turned out to be positive for dengue serology were retrospectively analysed with respect to patient’s age, gestational age, clinical presentation, complications, platelet counts and maternal as well as foetal outcomes.Results:Out of 300 females tested, 22 (7.3%) were found positive for dengue infection during the said time period. Out of them 9 were positive for IgM antibodies against dengue and 10 were found to be positive for NS1Ag, while 3 were positive for both IgM antibody and NS1Ag. Five patients presented with dengue in first trimester, 9 in second trimester and 8 in third trimester. Two patients had coinfections. Patient with coinfection of dengue with malaria had intrauterine death of fetus at 37 weeks while the second one having dengue with typhoid had a preterm vaginal delivery at 35 weeks.Conclusions:Establishing diagnosis of dengue infection in pregnancy is important for effective management by the obstetricians particularly the mode of delivery due to the potential risk of hemorrhage for both the mother and the newborn. Co-infections seen in endemic areas may be more common than usually reported.

Domestic violence in pregnancy in North Indian women.

BACKGROUND: Domestic violence against pregnant women in the Indian context, violence against women is frequently by family members other than the spouse/intimate partner/husband. AIMS: To study the incidence of domestic violence in pregnant North Indian women and the demographic features which put women at high risk for domestic violence. STUDY DESIGN: A prospective study at the Government Medical College and Hospital, Chandigarh from January 2004 to December 2004. PARTICIPANTS: Nine hundred and ninety-one pregnant women admitted to the pregnant women admitted to the antenatal ward were interviewed. STATISTICAL ANALYSIS: Test of significance used was Chi-square test. Odds ratio (OR) and 95% confidence interval (CI) was calculated. RESULTS: The incidence of domestic violence in this study was 28.4%. The violence was more when the husband was educated up to Class 10 level or lower (OR 2.07 (95%) CI 1.54 to 2.79), was habituated to alcohol (OR 2.31 (95%) CI 1 - 71 to 3.11) or to chewing tobacco (OR 2.77 (95%) CI 1.46 to 3.27) or to smoking cigarettes (OR 2.23 (95%) CI 1.59 to 3.11). The incidence of domestic violence was drastically high in women who were socially unsupported (OR 98.9 (95%) CI 43.65 to 235.68). The level of education and employment of the woman had no effect on the incidence of the abuse. The perpetrator of the abuse was the intimate partner (husband) in 48.2%, the husband's mother in 61.3%, and the husband's sister in 22.6%. Most often the abuse was by more than one person. CONCLUSIONS: The incidence of abuse was more when the male partner was less educated or in the habit of taking alcohol, opium or tobacco and in socially unsupported women. The level of education and employment of the woman had no effect on the incidence of abuse.

Burden of chronic severe anemia in obstetric patients in rural north India.

There were 5124 deliveries during January to December 2000 and of these 386 patients (7.53%) were severely anemic (Hb < 6.0 g/dl). 1083 units of blood were transfused to these patients, a mean of 2.80 units to each patient. There were 2 maternal deaths due to severe anemia. Of the 386 patients, 246 could be interviewed in detail and their demographic details were compared with 100 normal pregnant women with haemoglobin levels of 10 g/dl or more. In the anemic group 81.7% were illiterate, 62.1% had no antenatal check, 78.8% had no access to safe drinking water 90.65% had no toilet facilities and used open fields for defaecation, 63.1% reported having diarrhoea and pain in abdomen off and on. 20.73% reported history of passage of worms in the stools. History of previous menorrhagia was present only in 1.2%. The comparable figures in the non-anaemic group were 34% illiterate, 24% no antenatal checkup, 55% no toilet facilities, 38% unsafe drinking water, 6% diarrhoea, 2% (worms in stools) and 5% menorrhagia. Hence it is concluded that along with prophylaxis with iron and folic acid sufficient consideration should be given to sanitation facilities, safe drinking water, recurrent gastrointestinal infection etc.