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n Obstetrics and Gynaecology Forum - Ebola virus disease and pregnancy : guest editorial

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Abstract

Pregnant women with ebola virus disease (EVD) are at increased risk of severe disease and death compared to non-pregnant patients. Pregnancy loss is common in all trimesters, and women may be in labour at presentation. The fetus, placenta and amniotic fluid are highly infectious, and remain so even if the mother survives and is ebola PCR negative on blood testing. All liveborn neonates to date have died. This article will give an overview of the current outbreak in West Africa, and clinical presentation and management of EVD, and the challenges of managing pregnant women with EVD. Despite the good news that new infections in West Africa have now significantly declined, this is no time for complacency. Ebola virus disease may yet reach South Africa, either if there is a resurgence of cases, or in future outbreaks. It is vital that health care providers are prepared; this includes obstetricians and midwives. There have been no reported cases of pregnant women developing EVD who have travelled from the affected region to other countries, however this is not impossible. The final section of this paper will give guidelines for the diagnosis and management of ebola virus disease in pregnancy in a South African context. In an outbreak situation, the major challenge is maximising use of resources to optimise maternal survivial and keep health care workers safe from infection. In countries where sporadic, imported cases may occur, such as South Africa, the problem is identifying a pregnant woman who is an ebola suspect, given that there are no specific symptoms, and the differential diagnosis is of both obstetric and non-obstetric conditions is therefore wide.

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/content/medog/25/2/EJC169139
2015-05-01
2016-12-05
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