Pregnant women with dengue at higher risks, doctors warn

Medical experts have advised pregnant women to undergo dengue testing if they experience fever and, if the test results are positive, they should promptly seek admission in a hospital.

The current year has seen an alarming increase in cases of pregnant women contracting the mosquito-borne disease, they said.

Ruma Biswas, 26, who was nine months pregnant, lost her life to dengue on 27 July during treatment at Bangabandhu Sheikh Mujib Medical College Hospital in Faridpur. Prior to this, on 25 July, SM Nazia Sultana, senior assistant secretary of the Ministry of Commerce, also succumbed to dengue in the eighth month of her pregnancy. On 23 July, Bangladesh Bank Assistant Director Kanta Biswas, also eight months pregnant, faced the same fate.

Four pregnant women have died of dengue so far this year, Professor Dr Shahadat Hossain, Director, MIS, Directorate General of Health Services (DGHS), told The Business Standard.

Professor Dr Nahla Bari, head of the Department of Obstetrics and Gynaecology at MH Samorita Medical College, said, "It is essential to conduct a dengue test if a pregnant mother experiences symptoms such as fever, cold or cough.

"This year, an increase in pregnant mothers contracting dengue is evident. Two such patients were admitted to the ICU. Dengue during pregnancy heightens risks for both mother and child. Attention is essential on the fourth and fifth days of fever as patient conditions tend to deteriorate during this period."

Doctors emphasise the heightened danger of dengue during pregnancy due to the naturally weakened immune system.

Pregnant women face greater vulnerability to dengue haemorrhagic and shock syndrome. Infection carries serious risks for both the mother and the unborn child, leading to potentially severe complications, they said.

"Persistent vomiting in the initial pregnancy trimester can cause dehydration. If dengue coincides with this period, high fever exacerbates dehydration and lowers blood pressure, increasing risks of miscarriage," said Dr Nahla Bari.

According to the study, "Dengue Infection and Miscarriage: A Prospective Case Control", miscarriage and stillbirth are associated with dengue when the illness is severe. Dengue can also be transmitted directly from the ill mother through the placenta to the foetus in the later stages of pregnancy. Dengue infection is asymptomatic to mild only in almost 90% of cases and up to 20% of pregnancies miscarry.

A nurse at the Sheikh Hasina National Institute of Burn and Plastic Surgery, who had recently contracted dengue, experienced a miscarriage at 17 weeks of pregnancy.

Dr Ashraful Hoque, assistant professor at the blood transfusion department of Sheikh Hasina National Institute of Burn and Plastic Surgery told TBS, "Symptoms like headaches, chest-abdomen pain, and nausea which become evident during pregnancy can also happen in case of dengue. That is why we have to be careful."

"Proper fluid management is vital, as the body's fluid balance changes during pregnancy. Individualised care is necessary for pregnant women with dengue, requiring consistent medical follow-up," he said.

According to data from the Directorate General of Health Services (DGHS), the number of deaths due to dengue is higher among women this year. Around 57% of dengue deaths this year have been of women.

In the 24 hours till Friday morning, nine more deaths were reported from dengue, raising the fatalities from the mosquito-borne disease in Bangladesh to 453 this year. During the period, 1,565 more patients were hospitalised with the viral fever, the DGHS said.

The DGHS has recorded 95,877 dengue cases this year.