Mpox in pregnancy: Management, risks and challenges in Africa and lessons from the COVID-19 pandemic.

Autor: Ubom AE; Department of Obstetrics, Gynecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.; World Association of Trainees in Obstetrics and Gynecology (WATOG), Paris, France.; International Federation of Gynecology & Obstetrics (FIGO) Committee on Childbirth & Postpartum Haemorrhage, London, UK., Oiwoh SO; Dermatology and Venereology Unit, Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria., Ajiboye AD; Department of Obstetrics, Gynecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria., Nyeche S; Department of Obstetrics and Gynecology, University of Port Harcourt/University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria., Appiah-Kubi A; World Association of Trainees in Obstetrics and Gynecology (WATOG), Paris, France.; Department of Obstetrics and Gynecology, University of Health and Allied Sciences, Ho, Ghana., Sokunbi AE; Department of Medicine, Edo State University, Uzairue, Edo State, Nigeria., Mbiiza CM; World Association of Trainees in Obstetrics and Gynecology (WATOG), Paris, France.; University Teaching Hospital, Lusaka, Zambia., Olanrewaju FO; Department of Dermatology and Venereology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria., Ighorodje EE; Dermatology Unit, Department of Internal Medicine, University of Uyo Teaching Hospital, Uyo, Nigeria., Akinkugbe A; Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Akoka, Lagos State, Nigeria., Okoeguale J; Department of Obstetrics and Gynecology/Institute of Viral Hemorrhagic Fever and Emergent Pathogen, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria., Ojo OD; Department of Obstetrics, Gynecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria., Unwaha EA; Department of Obstetrics and Gynecology, West Suffolk NHS Trust, Bury St Edmunds, UK., Oriji PC; Department of Obstetrics and Gynecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria., Adebawojo TO; Ogun State Primary Healthcare Board, Abeokuta, Ogun State, Nigeria., Ekwebalam OP; Department of Obstetrics and Gynecology, Federal University Teaching Hospital, Imo State, Owerri, Nigeria., Okwaraoha TI; Department of Public Health, Imo State University, Owerri, Imo State, Nigeria., Ijarotimi OA; Department of Obstetrics, Gynecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.; Department of Obstetrics, Gynecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria., Eifediyi RA; Department of Obstetrics and Gynecology/Institute of Viral Hemorrhagic Fever and Emergent Pathogen, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria., Okogbenin SA; Department of Obstetrics and Gynecology/Institute of Viral Hemorrhagic Fever and Emergent Pathogen, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria., Okwor T; Department of Prevention Programme and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria., Ikimalo JI; Department of Obstetrics and Gynecology, University of Port Harcourt/University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria., Kuti O; Department of Obstetrics, Gynecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.; Feto-Maternal Medicine Unit, Department of Obstetrics, Gynecology and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria., Fasubaa OB; Department of Obstetrics, Gynecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.; Department of Obstetrics, Gynecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria., Ogoina D; Department of Internal Medicine, Infectious Diseases Unit, Niger Delta University/Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2023 Nov; Vol. 163 (2), pp. 466-475. Date of Electronic Publication: 2023 May 02.
DOI: 10.1002/ijgo.14810
Abstrakt: Data on mpox in pregnancy are currently limited. Historically, only 65 cases in pregnancy have been reported globally since mpox was discovered in 1958. This includes 59 cases in the current outbreak. Vertical transmission was confirmed in one patient. Pregnant women are at high risk of severe disease owing to immunological and hormonal changes that increase susceptibility to infections in pregnancy. African women appear to be at higher risk of mpox infection and adverse outcomes in pregnancy for epidemiological and immunologic reasons, in addition to the background high rates of adverse feto-maternal outcomes in the region. This risk is potentially heightened during the COVID-19 pandemic due to the possibility of mpox virus exportation/importation as a result of the lifting of movement restrictions and trans-border travels between countries affected by the current outbreak. Furthermore, coinfection with mpox and COVID-19 in pregnancy is possible, and the clinical features of both conditions may overlap. Challenges of diagnosis and management of mpox in pregnancy in Africa include patients concealing their travel history from healthcare providers and absconding from/evading isolation after diagnosis, shortage of personal protective equipment and polymerase chain reaction testing facilities for diagnosis, vaccine hesitancy/resistance, and poor disease notification systems. There is a need for local, regional and global support to strengthen the capacity of African countries to address these challenges and potentially reduce the disease burden among pregnant women in the continent.
(© 2023 International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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