MATERNAL health experts in the United States under the umbrella of the American College of Obstetricians and Gynaecologists have said that pregnant women can spread the monkeypox virus to their unborn babies through the placenta.
Citing data from the Centres for Disease Control and Prevention, the gynaecologists also said infected mothers could also spread the virus to their newborns through close contact after delivery.
The gynaecologists, in clinical information, published on the ACOG website, said the signs and symptoms of monkeypox virus infection in people who are pregnant appear similar to those in non-pregnant people with monkeypox virus infection, including fever, lymphadenopathy, lethargy, pharyngitis, headache, myalgias, and rash.
They said, “Pregnant people can spread the virus to their foetus through the placenta and through close contact with the newborn.
“Adverse pregnancy outcomes, including spontaneous pregnancy loss and stillbirth, have been reported in cases of confirmed monkeypox infection during pregnancy. Preterm delivery and neonatal monkeypox infection have also been reported.”
The maternal health experts pointed out that there were certain things obstetric care clinicians should know when diagnosing monkeypox in a pregnant individual.
They explained, “Rash in a person who is pregnant with risk factors for monkeypox virus infection needs to be differentiated from other skin conditions during pregnancy.
“Importantly, monkeypox lesions can mimic those of other skin infections such as molluscum contagiosum; and during the current outbreak, lesions have been common in the genital region.
“Therefore, monkeypox should be a differential diagnosis for any patient presenting with a rash or genital lesion.
“Patients with rashes initially considered characteristic of more common infections (e.g., varicella zoster or sexually transmitted infections should be carefully evaluated for a monkeypox rash.”
On the issue of breastfeeding, the gynecologists said direct contact between mothers in isolation for monkeypox and their newborns should be discouraged.
“The benefits of skin-to-skin contact and rooming-in on breastfeeding and infant physiology are well known; however, given the risk of neonatal transmission of monkeypox virus with close contact and potential for severe disease in newborns, direct contact between a patient in isolation for monkeypox and their newborn is not advised.
“This is until the criteria for discontinuing isolation have been met (i.e., all lesions have resolved, the scabs have fallen off, and a fresh layer of intact skin has formed),” the experts said.
The gynaecologists said clinicians should consult their infectious disease team as soon as monkeypox is suspected to ensure proper testing and reporting.