Dengue Infection Complicated by Severe Hemorrhage and Vertical Transmission in a Parturient Woman

Abstract

A Thai woman with a febrile illness was delivered of a healthy infant by cesarean section. The etiology of her 2-day fever was unknown at the time of surgery; results of serology performed later established a diagnosis of dengue infection. Postoperative hemostatic monitoring was not performed. She experienced massive and prolonged (8 days) wound hemorrhage that necessitated multiple transfusions of blood, platelets, and frozen plasma. The newborn became febrile on his 6th day of life. Dengue virus type 2 was isolated from his serum. Although the infant developed marked thrombocytopenia, his illness was brief and uncomplicated. This report emphasizes the hazards of surgical intervention in patients with acute dengue infection. We also believe it to be the first report of vertical transmission of dengue in humans.