Crimean-Congo Hemorrhagic Fever in Pregnancy: Two Cases from Turkey and a Review of the Literature

• Published in: Mediterranean journal of infection, microbes & antimicrobials microbes & antimicrobials, 2018-01, Vol.7
• Main Authors: ÇINAR TANRIVERDİ, Esra, ÖZKURT, Zülal, KAMALAK, Zeynep, DELİBAŞ, İlhan Bahri, PARLAK, Emine, GÖKTUĞ KADIOĞLU, Berrin
• Format: Article
• Language: eng ; tur
• Subjects: Crimean hemorrhagic fever; Crimean-Congo hemorrhagic fever; fetal mortality; Fetuses; Hemorrhage; Literature reviews; Maternal mortality; Mortality; Pregnancy; tick
• ISSN: 2147-673X; 2147-673X
• DOI: 10.4274/mjima.2018.12

Crimean-Congo Hemorrhagic Fever (CCHF) is a serious viral disease. There are limited data about clinical course of the disease during pregnancy. Here we reported two pregnant cases with CCHF, who are farmers and have tick-bite history. Thrombocytopenia, leukopenia, elevated liver enzymes were noted in both cases. The diagnosis was made by CCHFV-PCR or IgM positivity. Supportive therapy was given to the patients, but ribavirin was not. Blood product was not need in first case, and three apheresis thrombocyte suspensions were given in second case. Mothers were treated successfully and improved. Pregnancy was resulted in abortion in the first case. The pregnancy continued without any problem in second case and healthy baby was born. Overall 15 cases were reported from Turkey. Maternal and fetal mortality rates were found 6.6% (1/15) and 40% (6/15) respectively in Turkish cases. Fetal lost was found 3/4 in first trimester, 4/8 in second trimester, and 2/7 in third trimester. There was hemorrhage in 8 of 15 pregnants (53.3%). Maternal mortality was recorded 1/8 (12.5%) in case with bleeding, and fetal/neonatal mortality was 6/6 in fetus of whose mothers with bleeding. CCHF during pregnancy is rare but important clinical condition. Clinical severity is of great importance for mother survival, and both gestational week and mother"s clinical condition are important for fetus health. Virus may be transmitted as vertical and fetal infection may cause intrauterine death. CCHF should be considered in women with vaginal bleeding in endemic area.