Blood, birthing and body fluids: delivering and staying alive in an Ebola Management Centre
Channel: F1000
Date: 10/06/2015

Severine Caluwaerts, MSF, disucsses that data on pregnancy complicated by Zaire-strain Ebola virus disease (EVD) are scarce. Maternal mortality with EVD is usually around 90%, foetal/neonatal mortality of transplacental infection is 100%. Suspected/confirmed EVD in pregnancy poses practical and ethical challenges, and often causes anxiety in medical personnel due to risks around body fluids at delivery. In a retrospective analysis of routine programme data, we aimed to describe the pregnant EVD survivors, the EVD/pregnancy management protocol used during the 2014/2015 West Africa epidemic, and the foetal/neonatal outcome of transplacental EVD infection. This is the largest case series of pregnant EVD survivors reported. A survival rate is unknown; this can only be reported if pregnancy tests are done systematically at admission. Foetal mortality was 100%. First-trimester pregnancies were underreported, probably due to initial absence of routine pregnancy testing at admission. Amniotic fluid EVD-PCR remained EVD-positive after cure of the patient, which has possible implications for the infectivity of cured pregnant women.

Slides are available to download here: http://f1000research.com/slides/1000081.

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