A team of doctors successfully treated a preterm newborn who acquired dengue from her mother. The baby was delivered via emergency cesarean section and developed dengue as a result of perinatal transmission of the virus.
Patient Avantika Patil (name changed) a resident of Vishrantwadi, Pune, Working with a private limited company. She was elated about her first pregnancy. Unfortunately, she acquired dengue a week before her pregnancy. She had symptoms like joint pain, fever on and off, and dehydration. She was admitted to a private hospital at 36+5 weeks of pregnancy on 29th July wherein an emergency C-section was done to save the mother and the baby.
Dr Siddharth Madabhushi, Consultant Neonatologist from Pune, said, “A 36+5 weeks late preterm female baby of weight 2.33 kg was born by emergency caesarean section given the preterm onset of labour to 33 years old primigravida mother. The mother had complaints of fever 3 days before delivery. The mother tested positive for dengue and presented with a low platelet count. Initially, the baby had a weak cry, and required resuscitation soon after birth.”
What is Perinatal dengue?
Perinatal dengue refers to the transmission of the dengue virus and sometimes just the antibodies to the dengue virus from a mother to her baby during pregnancy, delivery, or shortly after birth. If a mother is infected with dengue during pregnancy, the virus and antibodies can cross the placenta and infect the baby. Mother-to-child transmission occurs both in early and late pregnancy, but it is more likely to occur in the third trimester. Possible effects of dengue on the unborn child are- the child may be born with dengue, preterm birth, low birth weight, possible miscarriage, and stillbirth. Newborns usually develop symptoms within 14 days of birth (commonly within the first week), but most babies are asymptomatic. Clinical presentation in babies varies from mild symptoms to severe dengue with shock and hemorrhagic manifestations. The majority of neonates experiencing perinatal dengue symptoms tend to show signs of recovery within a short period of 5-7 days.
“This baby was shifted to NICU and was kept on oxygen support for 2 days and was started on IV fluids. Given hemodynamic instability, medicines needed to increase blood pressure were started and the baby received multiple blood products due to bleeding-related complications during the NICU stay. Subsequent blood counts showed a decrease in platelet count (platelet – <10,000). Due to strong suspicion of neonatal dengue in the setting of maternal dengue, a workup for dengue was done where dengue IgG and NS1 came positive. Gradually there was recovery in platelet count and the baby was discharged from the hospital weighing 2.45 kg on day 8 of life. Both mother and child are in good health, and the baby is meeting developmental milestones appropriate for her age,” highlighted Dr. Anusha Rao, Consultant Neonatologist & Paediatrician.
“If the mother has been infected with dengue fever during childbirth, it is essential to continuously monitor the health of the newborn, even after discharge from the hospital. Adequate hydration and rest for both the mother and the newborn is essential. If a mother can breastfeed, she should continue to do so, as breast milk provides essential nutrients for the newborn which help boost their immune system. Frequent hand washing should be done before and after each feeding. Avoid close contact with people who are infected. There is no specific vaccine or medicine for dengue treatment during pregnancy. Pregnant women should be extremely cautious and adopt safe practices such as preventing mosquito bites by wearing long sleeves and pants outdoors. Avoid staying in humid places and keep the surroundings clean. If you are infected, talk to your doctor immediately,” concluded Dr Siddharth.
