Women who contract monkeypox while pregnant are being advised to have a C-section in order to prevent their newborn from also becoming infected, according to new research published in the journal Ultrasounds in Obstetrics & Gynecology.  Cases are spreading across the United Kingdom, and a few have been reported in the United States, but levels are nowhere near what would constitute a pandemic like the novel coronavirus.Monkeypox is a variant of smallpox.  It causes flu-like symptoms including swollen lymph nodes and a rash that can start in any area of the body.  This eventually turns from red bumps to blisters.  The newest wave of monkeypox was first reported in the U.S. in May 2022 after the individual had traveled to Africa, where is it far more common.

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Edward Morris, one of the authors and president of the Royal College of Obstetricians and Gynecologists, provided the following statement regarding the team’s paper:“This paper written by leading medical experts synthesizes available evidence on the monkeypox virus and makes recommendations on what needs to be done to ensure a pregnant woman and her baby are cared for if they have, or are suspected of having, the virus.  The World Health Organization states there could be adverse consequences for pregnant women and babies if they become infected including congenital monkeypox, miscarriage or stillbirth, which is why we have provided clear guidance for healthcare professionals in this paper.”Dr Camilla Kingdon, President of the Royal College of Paediatrics and Child Health (RCPCH), and Dr Helen Mactier, President of British Association of Perinatal Medicine (BAPM) added, “There is a shortage of information at present about the spread of monkeypox in the U.K., and its impact on pregnant women and newborns.  This paper is therefore an important source of information to aid clinicians at a time when the numbers of cases in the UK is rising.”Soon-to-be mothers might be able to transmit the virus either during or after they give birth and infants, born with low immunity, would have a hard time fending it off and making a full recovery.  There is no evidence thus far on what the best way to deliver is should a mother contract monkeypox but having a C-section would help to prevent the baby from being directly exposed, particularly if the mother has genial lesions.“If genital lesions are identified on a pregnant woman, then a caesarean birth will be recommended,” the authors wrote. “If a pregnant woman or person has suspected or confirmed monkeypox, a caesarean birth will be offered following discussion of the possible risk of neonatal infection, which may be serious.”Mothers should, according to the team, also minimize direct contract with their child post-delivery until the lesions have resolved.  Skin-to-skin contact increases the risk of the baby becoming infected.  This means that breastfeeding is also off limits.  Mothers who intend to breastfeed should extract and discard their milk until the isolation period has ceased.“Pregnant women who become infected may also consider getting vaccinated,” the authors wrote.  However, they caution that receiving a vaccine up to two weeks following exposure will not prevent the virus.   It may reduce symptom severity.“The decision whether to have the vaccine in pregnancy should be a personal choice,” the authors concluded. “Pregnant women and people should be encouraged to discuss the risks and benefits of vaccination, including possible side effects, with a healthcare professional before making their final decision.”

Sources:

Ultrasound in Obstetrics & Gynecology: “Monkeypox and pregnancy: What do obstetricians need to know?”New paper provides best practice for managing monkeypox in pregnancyPregnant Women With Monkeypox Advised to Have C-Section