Available scientific information suggests that contagion by the monkey pox during pregnancy may pose risks to the fetus.
However, bodies such as World Health Organization and the Centers for Disease Control and Prevention (CDC) from the United States, state that data on infection during pregnancy are limited at this time.
It is not known, for example, if pregnant women are more susceptible to the virus or if the infection is more severe in pregnancy. The transmission of virus it can occur across the placenta from the mother to the fetus, which can lead to congenital smallpox, or during close contact at and after birth.
The WHO says more research is needed to understand the risks of smallpox during pregnancy and how the virus can be transmitted to the fetus in the womb or to the newborn during or after birth, or during breastfeeding.
Therefore, the WHO recommendation is that pregnant women avoid close contact with anyone diagnosed with the disease. In the face of suspected exposure, medical attention should be sought for testing and implementation of necessary care.
O Ministry of Health published a technical note with specific guidelines on infection by pregnant women, women who have recently had a child (puerperal women) and who are breastfeeding.
According to the document, follow-up should be carried out following the time of infection and the gestational period.
The note informs that pregnant women have symptoms similar to non-pregnant women, mild and self-limiting conditions. In addition, there is no indication to anticipate delivery.
Despite the illness caused by the virus monkeypox be considered a self-limiting disease, which usually presents spontaneous cure, in some cases, there may be a need for specific drug treatment, especially in immunosuppressed people.
In most cases, only symptomatic treatment is indicated for fever and pain. In cases with more significant lesions, medication may be considered after medical evaluation.
the infectious disease doctor Natalie Del Vecchio from the National Institute of Health for Women, Children and Adolescents Fernandes Figueira (IFF/Fiocruz ), explains that the virus can cross the placenta and reach the fetus.
“Maternal-fetal transmission from the placenta is recognized, leading to congenital disease, spontaneous abortion, fetal death and premature birth. However, data on the disease during pregnancy are limited because it is a new disease and there are few studies”, says Natalie.
The specialist recommends that pregnant women be monitored and the use of personal protective equipment for health professionals.
“The puerperal woman must remain in a place where contact and droplet precautions are taken, ideally a private room, while maintaining the safety of other patients”, she explains.
According to the infectologist, cesarean surgery is not indicated and the choice of delivery is based on obstetric indications.
“The indication of cesarean section occurs when the patient has a genital lesion, because there is a risk of contact and neonatal infection at the time of passage through the birth canal”, he points out.
Isolation and breastfeeding
You Centers for Disease Control and Prevention (CDC) warn that, due to the risk of transmission and the potential risk of serious illness for newborns, direct contact between the patient in isolation and the child is not recommended.
Separating the patient and the newborn, including between rooms, is the best way to prevent transmission to the child. The CDC states that the patient should be counseled about the risks of contagion and serious illness to the newborn.
If isolation cannot be maintained, the CDC recommends that there should be no direct skin-to-skin contact.
The newborn must be fully clothed or swaddled and, after contact, the clothing or blanket must be removed and changed.
In addition, new gloves and gowns must be worn by the patient at all times. The patient must wear a mask during the meeting with the child.
About breast-feeding the CDC recommends deferring until the criteria for discontinuing isolation are met, which includes improvement of lesions, with scab shedding and new skin forming.
Other recommendations
The main mode of transmission of smallpox from monkeys is through direct person-to-person contact, called skin-to-skin.
Contagion can happen from contact with skin lesions, crusts or body fluids of an infected person, by touching objects, fabrics (clothes, sheets or towels) and surfaces that were used by someone with the disease, in addition to contact with secretions. respiratory.
The Ministry of Health recommends avoiding close contact with people suspected or diagnosed with the disease, in addition to washing hands with soap and water or with alcohol gel before eating or touching the face as a preventive measure.
In the presence of a suspicious symptom (see below ), people should seek medical care at Basic Health Units (UBSs) or Emergency Care Unit (UPA) for evaluation.
The recommendations of the Ministry of Health for pregnant, postpartum and lactating women are:
- Avoid contact with people who have suspicious symptoms
- Using condoms for all types of sexual intercourse (oral, vaginal or anal)
- Watch for possible partner injuries
- Maintain the use of masks, especially in environments with potentially infected people
- Seek medical care in the face of suspicious symptoms
disease symptoms
Monkeypox, in most cases, progresses without complications and signs and symptoms last from two to four weeks.
Clinical manifestations usually include skin lesions in the form of blisters or sores that can appear on different parts of the body, such as the face, hands, feet, eyes, mouth or genitals.
However, the current outbreak of the disease has presented different epidemiological characteristics, with symptoms that can be quite mild.
In the most common documented form of the disease, symptoms may appear from the seventh day onwards with a sudden and intense fever.
Signs such as headache, nausea, exhaustion, tiredness and especially the appearance of swollen glands are common, which can happen both in the neck and in the axillary region as well as in the genital part.
The manifestation on the skin occurs between one and three days after the initial symptoms. The signs go through different stages: macula (small spots), papule (small pimple-like sores), vesicle (small blisters), pustule (bubble with the presence of pus) and crust (which are the healing shells).
Source: CNN Brasil
