THE monkey pox may pose a higher risk of severe symptoms for newborns, children and people with immune deficiencies. However, data on infection during pregnancy are limited.
It is not known, for example, if pregnant women are more susceptible to the virus or if the infection is more severe in pregnancy. Monkeypox virus can be transmitted to the fetus during pregnancy or to the newborn by close contact during and after birth.
“WHO recommends that countries take steps to reduce the risk of transmission to other vulnerable groups, including children, pregnant women and those who are immunosuppressed,” World Health Organization (WHO) Director-General Tedros Adhanom told the press. .
While more research is needed to better explain the risks of smallpox during pregnancy, the Ministry of Health has published a technical note with specific guidance on infection in pregnant women.
“As with other viral infections, it can increase the risk of miscarriage, fetal death, prematurity and other changes linked to fetal involvement. However, there is still no way to quantify these risks. Even so, extra care with the pregnant woman and the fetus is recommended in the event of suspicion or confirmation of infection, until more robust data are available”, states the document.
How to be monitored during pregnancy
According to the Ministry of Health, monitoring should be carried out according to the time of infection and the gestational period.
In the first trimester, the folder recommends the evaluation by ultrasound to analyze the viability of pregnancy. In moderate, severe and critical cases in the second trimester, the examination should be performed with detail of biometry, anatomical evaluation and quantification of amniotic fluid.
In the third trimester, the well-being of the fetus can be assessed using an exam called Dopplerflowmetry, which allows analyzing the blood circulation of the mother, placenta and baby.
After the 26th week, cardiotocography is still recommended, which makes it possible to observe aspects of the fetal heartbeat in moderate, severe and critical cases.
According to the ministry, the risk to the fetus is low after the infection resolves. However, ultrasound is recommended every four weeks to assess growth and well-being. For specific cases, in the face of evidence of liver enlargement (hepatomegaly) or abnormal fluid accumulation (fetal hydrops), a separate evaluation may be necessary.
The ministry does not recommend performing amniotic fluid analysis widely, since the sensitivity for molecular detection of the virus in the fluid is unknown.
“By analogy with other viral infections, it is assumed that the virus can be found in the amniotic fluid from 18 to 21 weeks of gestation. The indication of amniocentesis, so far, is not routine, being reserved for specific cases or clinical research scenarios”, says the technical note.
prevention measures
The technical note from the Ministry of Health also recommends preventive measures, considering the rapid increase in the number of cases in Brazil and in the world, associated with transmission by direct contact and, eventually, by air.
The guidelines include maintaining the use of masks, especially in environments with individuals potentially contaminated with the virus, and distancing people who have suspicious symptoms such as fever and skin lesions.
Pregnant women should use condoms in all types of sexual intercourse (oral, vaginal, anal) since transmission through intimate contact has been the most frequent, according to the ministry.
The document also recommends attention to lesions in the genital area of sexual partners and seeking medical attention in the event of suspicious symptoms.
The signs and symptoms of the disease can last between two and four weeks. The disease begins, in most cases, with a sudden, strong and intense fever. The patient also has headache, nausea, exhaustion, tiredness and fundamentally the appearance of ganglia (swellings popularly known as “inguas”), which can happen both in the neck region, in the axillary region, and in the genital region.
The manifestation on the skin occurs in the form of blisters or lesions that can appear on different parts of the body, such as the face, hands, feet, eyes, mouth or genitals.
Breast-feeding
Considering the knowledge that the virus can be transmitted to the newborn by close contact during or after childbirth and the disease can have a serious evolution in this age group, the ministry recommends avoiding skin-to-skin contact between the mother and the newborn. , perform a macroscopic examination of the child immediately after birth and collect samples of the baby’s throat and any skin lesions.
Women should be informed about the risks of infection and the need to keep mother and child in separate rooms during the maternal isolation phase.
Faced with the impossibility of maintaining isolation in separate rooms, the ministry recommends that the child be fully clothed or wrapped in a blanket – after contact, the clothing or blanket should be immediately replaced. The mother must wear gloves and an apron, covering the entire area of skin below the neck, in addition to wearing a well-fitting surgical mask.
WHO recommends that the risks of transmission during breastfeeding be assessed on a case-by-case basis by medical staff. “If it is possible for you to continue breastfeeding and have close contact, they will advise you on how to reduce your risk by taking measures such as covering your injuries and wearing a mask to reduce the risk of transmitting the virus,” the WHO says.
According to the WHO, it is not yet known whether the monkeypox virus can be transmitted through breast milk, an area that needs further study.
Source: CNN Brasil
