Guidelines For The Management Of Pregnant And Breastfeeding Women In The Context Of Ebola Virus Disease

The Democratic Republic of Congo is currently experiencing the second largest Ebola outbreak in history, following a 2014-2016 outbreak in western Africa that had an estimated 28,000 cases. Investigational treatment and vaccination trials are ongoing, but data in the context of pregnancy and breastfeeding are limited. A paucity of scientific evidence exists on how to best treat pregnant or breastfeeding women with suspected or confirmed Ebola virus disease (EVD). Historical reports suggest that, among women who acquire EVD during pregnancy, there is increased mortality and morbidity, and a near 100% rate of adverse pregnancy outcomes. To save the lives of mothers and their babies, mitigate complications, and limit the spread of disease, it is critical that recommendations are made on the prevention, treatment, and surveillance of women who are exposed to EVD, acquire EVD during pregnancy or breastfeeding, or survive EVD with ongoing pregnancies. These guidelines are the first to provide such recommendations.

In this issue of Clinics in Perinatology, guest editors Joseph B. Cantey and Andi Shane bring their considerable expertise to the topic of Perinatal and Neonatal Infections. Provides in-depth, clinical reviews on Perinatal and Neonatal Infections, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

This book is a complete guide to the diagnosis and management of any infectious disease which may affect the mother or the fetus during pregnancy. Pregnancy is a unique condition in which the interplay of endocrine and immune influences leads to altered severity and susceptibility to infectious diseases. These infections, in turn, are a substantial cause of maternal and perinatal morbidity. The book discusses the immunologic, clinical and epidemiologic evidence for altered responses during pregnancy. Several infections have unique consequences in pregnancy. Some infections have vertical transmission, and their management focuses on decreasing perinatal transmission. Others can be transmitted transplacentally and cause congenital infection. While still, other common infections like gastroenteritis, UTI, tuberculosis, leprosy or certain dermatological and oral conditions can cause pregnancy complications. This book discusses all such diseases in detail as well as suggests means for early identification and appropriate treatment for them. A separate chapter adequately covers the novel coronavirus infection associated with management challenges in pregnant women. The book includes dedicated sections on postpartum infections and fetal outcomes associated with maternal infections. It reviews strategies to prevent infection in obstetrics that plays a key role in decreasing the global burden of maternal morbidity and mortality. The book is relevant for practicing obstetricians and gynecologists, post-graduate students of obstetrics and gynecology as well as general practitioners, family medicine specialists, primary health care workers and undergraduate medical students.

The definitive reference in the field for more than 35 years, Creasy and Resnik's Maternal-Fetal Medicine provides today’s MFM practitioners with authoritative, comprehensive guidance on every aspect of this fast-changing field. The fully revised 9th Edition brings you up to date with the latest evidence-based guidelines and research as well as the fundamental scientific foundation needed for effective practice, helping you minimize complications and ensure the best possible outcomes for your patients. Renowned experts in obstetrics, gynecology, and perinatology provide valuable information in every area of complex obstetric care, highlighting the most commonly encountered anomalies and providing clear guidelines for obstetric and neonatal management. Offers comprehensive updates on rapidly changing topics, including extensively revised genetic content throughout. Includes two new chapters: maternal and fetal viral infections, including COVID-19; and sexually transmitted disease, covering the epidemiology, pathogenesis, diagnosis, and treatment of individual infectious diseases that may complicate pregnancy. Contains user-friendly features such as numerous diagnostic and treatment algorithms for quick access to current protocols; key points at the end of each chapter; and counseling pearls with practical guidance on patient consultation. Features a comprehensive imaging section, including a video library to aid in everyday diagnosis. Shares the expertise of a renowned editorial team—including new co-editors Drs. Lorraine Dugoff and Judette M. Louis—who lead authors representing top institutions from around the globe.

This comprehensive account of the deadliest Ebola outbreak in history examines its devastating effects on West Africa’s most vulnerable populations: pregnant women and children. Noted experts across disciplines assess health care systems’ responses to the epidemic in Liberia, Guinea, and Sierra Leone, emphasizing key areas such as pregnancy, prenatal services, childbirth, neonatal care, and survivor health among pregnant and non-pregnant women. The 30 chapters hone in on gender-based social issues exacerbated during the outbreak, from violence against women and girls to barriers to female education. At the same time, chapters pinpoint numerous areas for service delivery and policy improvements for more coordinated, effective, and humane actions during future pandemics. A sampling of the topics: Ebola virus disease: perinatal transmission and epidemiology Comprehensive clinical care for children with Ebola virus disease Maternal and reproductive rights: Ebola and the law in Liberia Ebola-related complications for maternal, newborn, and child health service delivery and utilization in Guinea The Ebola epidemic halted female genital cutting in Sierra Leone—temporarily Maternity care for Ebola at Médecins Sans Frontières centers Stigmatization of pregnant women with and without Ebola Exclusion of women and infants from Ebola treatment trials Role of midwives during the Ebola epidemic Pregnant in the Time of Ebola is a powerful resource for public health specialists, anthropologists, social scientists, physicians, epidemiologists, nurses, midwives, and governmental and non-governmental agency staff studying the effects of the epidemic on women and children as a result of the most widespread Ebola outbreak to date.

Ebola virus disease (EVD) is a life-threatening disease caused by Ebola virus (EBOV; Zaire ebolavirus). Viruses of the genus Ebolavirus (of the family Filoviridae) can cause life-threatening disease. EBOV causes outbreaks of EVD, historically the most severe and most frequent. This guidance, due to the evidence available, is directed only to the treatment of EVD, the disease caused by EBOV (Zaire ebolavirus). During early EVD, patients present with a non-specific febrile illness, followed by gastrointestinal signs and symptoms that frequently lead to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. EVD case fatality remains high, with a pooled case fatality rate of 60% (95% confidence interval [CI]: 47–73%) in outbreaks from 2010–2020. Following the publication of an RCT demonstrating superior efficacy of two EVD therapeutics, in comparison to the ZMapp control arm, WHO proposed to develop a new guideline. This is a new guideline written to accompany the optimized supportive care (oSoC) for EVD standard operating procedures. The guideline aims to summarize high quality evidence for EVD therapeutics and make recommendations for their use.