Dengue Shock Syndrome Complicating High Risk Twin Pregnancy during Late Gestation: Extinguishing Fuel added Flames

Arpita Jaiswal,Dhruv Talwar,Manila Reddy Eleti,Neema Acharya,Sparsh Madaan,Sunil Kumar

doi:10.9734/jpri/2021/v33i43b32557

Abstract

Incidence of Dengue has been on the up rise ever since the second wave of the pandemic of COVID19 has ended introducing an old enemy on the frontline to the health care professionals.A 28 year old Gravida 2 Parity 0 Living 0 Abortion 1 with twin pregnancy presented with fever along with chills and retro orbital pain along with body ache since two days in the emergency department with the gestational age of 36 weeks.She tested positive for Dengue NS1 antigen.Patient was having thrombocytopenia and was managed with intravenous fluids,platelet and blood transfusion and was taken for caesarian section and she delivered twins with normal birth weight.During the post operative period the patient went into dengue shock syndrome and which was managed with fluids and inotropic support and patient ultimately recovered and was discharged on day seventeen of admission .This case report emphasises on the importance of prompt detection and management of dengue in a case of high risk pregnancy such as twin pregnancy.After extensive review of literature we found that this is the first case report to report the association of twin pregnancy with dengue shock syndrome making it an important topic of discussion.

Highlights

Dengue fever is a tropical disease challenging the health care facilities after the second wave of COVID19 [1].It is a flavivirus infection transmitted by Aedes mosquito [2].It is endemic in India with increased incidence in the monsoon season owing to the rainfall pattern
In this brief case report we report a case of 28 year old Gravida 2 Parity 0 Living 0 Abortion 1 with twin pregnancy who reported with dengue fever and thrombocytopenia and was taken for caesarean section and later developed dengue shock syndrome
This thrombocytopenia was managed with platelet transfusion as patient had to be taken for immediate caesarian section

Summary

INTRODUCTION

Dengue fever is a tropical disease challenging the health care facilities after the second wave of COVID19 [1].It is a flavivirus infection transmitted by Aedes mosquito [2].It is endemic in India with increased incidence in the monsoon season owing to the rainfall pattern. Dengue usually presents with high grade fever along with chills accompanied with headache or retro orbital pain. Dengue fever is associated with numerous complications in pregnancy ranging from maternal mortality to still birth, pre term deliveries, anomalities in the foetus and neonatal deaths. Age of 36 weeks presented to the emergency department with the chief complaint of high grade fever with chills along with retro-orbital pain and body ache with red coloured spots on the lower limb since two days. Twin pregnancy in itself is a high risk pregnancy associated with preterm delivery, perinatal mortality, growth restriction of the foetus and congenital abnormalities. In this case report we postulate a relationship between severe dengue and twin pregnancy. In this brief case report we report a case of 28 year old Gravida 2 Parity 0 Living 0 Abortion 1 with twin pregnancy who reported with dengue fever and thrombocytopenia and was taken for caesarean section and later developed dengue shock syndrome

CASE REPORT

DISCUSSION

CONCLUSION