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Infectious Diseases in Pregnancy

• Editor's Note
• List of Articles

List of Articles

• Malaria During Pregnancy
  Malaria during pregnancy is a severe disease. It increases the risk of adverse pregnancy outcomes, including low birth weight, pregnancy loss, and preterm birth; this prevention and prompt diagnosis and treatment are essential. The advisory emphasized the importance of considering malaria in the differential diagnosis of fever of unknown origin, even in patients without a history of travel to countries with known transmission. The advisory highlighted the importance of early diagnosis and treatment to avoid the development of severe malaria, a potentially fatal condition, and to reducing ongoing transmission to local mosquitos. The release of this advisory prompts a review of malaria for obstetricians and other healthcare professionals focusing on the effects of malaria on the pregnant patients, the fetus, and the newborns and recommendations for prevention and treatment of malaria during pregnancy. The Global technical strategy for malaria 2016 – 2030 was adopted by the World Health Assembly in May 2015. It provides a comprehensive framework to guide countries in their efforts to accelerate progress towards malaria elimination.
  
  
• Tuberculosis in Pregnancy
  Untreated tuberculosis (TB) disease represents a greater hazard to a pregnant woman and her fetus than does its treatment. Streptomycin in the only anti-TB drug documented to have harmful effects on the human fetus (congenital deafness) and should not be used. Pyrazinamide (PZA) can probably be used safety during pregnancy and is recommended by the World Health Organization (WHO) and the International Union Against Tuberculosis and Lung Disease (IUATLD). If PZA is not included in the initial treatment regimen, the minimum duration of therapy is 9 months. For pregnant women with multidrug resistant (MDR) TB treatment should be done in consultation with the multidrug resistant TB expert. Many of currently medications currently used for treatment of multidrug resistant TB may be harmful to the fetus. Most patients with previously untreated pulmonary TB disease can be treated with either a 6-month or a 9-month regimen, although the 6-month regimen is used for the majority of patients. All 6-month regimens must contain INH, RIF, and initially, PZA. The goal is to complete all doses within 1 year.
  
  
• Hepatitis C Virus Infection and Pregnancy
  Hepatitis C virus (HCV) infection has been called a silent epidemic, because after infection, many individuals are unrecognized and untreated until years later. The review describes the prevalence of HCV infection during pregnancy, evaluate current risk factors associated with HCV antibody positivity, and identify novel composite risk factors for identification of groups most likely to demonstrate HCV antibody seropositivity in an obstetric population. It has been shown that infants born to HCV-positive women are more likely to have low birth-weight, be small for gestational age, be admitted to the intensive care unit, or require assisted ventilation. Universal HCV screening during the pregnancy is a fair, realistic, strategy which should be implemented in healthcare systems worldwide. In this review, we have also provided an up-to-date overview of the existing evidence on the pediatric use of direct-acting antivirals (DAAs), summarizing indications to treatment and recommendations for monitoring.
  
  
• Novel Coronavirus (COVID-19) Disease and Pregnancy
  Novel coronavirus (COVID-19) is an emerging, rapidly evolving situation. The Women’s Health and Education Center's (WHEC's) publications in collaboration with the United Nations (UN) and the World Health Organization (WHO) will provide updated information as it becomes available. All individuals, including pregnant individuals, are encouraged to take precautions to avoid exposure to COVID-19 as the pandemic evolves. Pregnant women admitted with suspected COVID-19 or who develop symptoms suggestive of COVID-19 during admission should be prioritized for testing. Mother-to-child transmission of COVID-19 during pregnancy is unlikely, but after birth a newborn is susceptible to person-to-person spread. The mode of delivery should be individualized and based on a woman's preferences alongside obstetric indications. Cesarean sections should only be performed when medically justified. In limited studies COVID-19 has not been detected in breast milk. As the situation evolves, this document may be updated or supplemented to incorporate new data and relevant information.
  
  

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