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Federación Mexicana de Ginecología y Obstetricia, A.C.

2022, Number 04

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Ginecol Obstet Mex 2022; 90 (04)

Extreme maternal morbidity (near miss) for severe dengue. A case report

Escalante-Rosique JR, Tejeda-Mollinedo W, García-Hernández GG, Betanzos-Ramírez F, Martínez-Hernández CM

Language: Spanish
References: 16
Page: 364-370
PDF size: 349.37 Kb.


ABSTRACT

Background: Dengue is caused by a virus belonging to the Flaviviridae family, there are four related serotypes: DENV-1, DENV-2, DENV-3, DENV-4 transmitted by the bite of the female mosquito of the species Aedes aegypti and Aedes albopictus.
Clinical case: 19-year-old female patient, 36 weeks pregnant by date of last menstrual period and diagnosed with dengue due to positive serology (Ag-NS1) and thrombocytopenia (68,000/mm3). The illness started with fever of 38.0°C, of three days of evolution accompanied by arthralgias, myalgias, retro ocular pain and uterine contractions. The patient was admitted to the intensive care unit due to respiratory failure (which required invasive mechanical ventilation), acute renal and hematologic failure, following cesarean section. She required surgical reintervention for intra-abdominal bleeding due to coagulation disorders. During her hospital stay she required 50 platelet concentrates, 8 erythrocyte concentrates, 14 fresh plasmas and 4 platelet apheresis. After 14 days of hospital stay he was discharged due to clinical improvement.
Conclusion: If no immediate action is taken, severe dengue is a cause of fatal mother-child outcome. The timely identification of the complications associated with this disease in pregnant women highlights the importance of prevention, early diagnosis and treatment. Similarly, it is important that in pregnant patients with this comorbidity, the obstetrics service should intervene in a timely manner in pre- and post-surgical surveillance.


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