Smallpox in pregnant women – symptoms, treatment, prognosis

Contact with smallpox during pregnancy most often affects women caring for older children infected with the disease. Fortunately, due to the immunity produced in the past in a mother who has undergone smallpox or been vaccinated, infection during pregnancy is rare.

What does smallpox look like in pregnant women? Symptoms, course of disease

Smallpox in pregnant women is characterized by a severe course. Infection occurs via the droplet route when an infected person in close proximity sneezes or coughs. Contact with smallpox during pregnancy usually affects women caring for children. If they become infected, they can pass the pathogen across the placenta. Fortunately, this type of situation is relatively rare due to the immunity produced in the mother after passing a disease in the past or as a result of vaccination. Smallpox during pregnancy initially manifests as fever, general weakness, elevated body temperature, headache and abdominal pain. After 2-3 days, there are flare-ups of an itchy rash on the face and torso and extremities. The skin lesions evolve from macules, through papules from a few millimeters to 1 centimeter in diameter, vesicles, pustules and scabs. Skin eruptions tend to dry up and absorb, but often leave behind discoloration and scarring. Once a woman has survived an attack of the virus, it remains in her body in a lethal, or dormant, state for the rest of her life. Reactivation can occur in the form of hemiplegia and manifest itself in the affected dermatome (an area of skin, sensory supplied by a specific spinal nerve).

Is smallpox dangerous in pregnancy? Complications, prognosis

Smallpox in pregnancy is usually associated with dangerous complications for both the woman and the unborn child. Depending on the trimester, it can cause different complications. The mother-to-be most often experiences pneumonia, while the consequences for the baby can be more dangerous. Smallpox in the first trimester is particularly dangerous, and can even lead to the death of the embryo. The virus also poses the risk of a variety of malformations and disorders most often involving the nervous system, limb deformities, skin scarring or visual defects. Equally dangerous is smallpox during pregnancy just before termination and during the postpartum and lactation periods. It then poses a risk of transmitting the virus to the child, but also manifests more dangerous symptoms than usual, such as shortness of breath, coughing, post-rash scarring, susceptibility to bacterial infections and even sepsis, meningitis, thrombocytopenia or nephritis and hepatitis.

Treatment of smallpox in pregnancy

Smallpox in pregnancy requires immediate treatment. Treatment of the disease is determined by the trimester in which the infection occurred. First of all, pharmacological treatment of the pregnant mother with antiviral preparations that inhibit the multiplication of the pathogen is recommended, including in the situation of perinatal infection. In the case of infection in the last trimester, immunoglobulins targeting chickenpox and shingles are administered to the newborn. Topical antihistamines are recommended for itching and skin lesions, as well as baths with potassium permanganate or baking soda. Preventive therapy is also given to high-risk women, i.e. ladies who are in contact with a sick person, did not go through smallpox in childhood and were not vaccinated against it. In the case of a disease such as smallpox, treatment is provided in an outpatient setting. Hospitalization is necessary only if additional symptoms appear, such as from the respiratory and digestive systems, spotting or bleeding from the genital tract.