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Leptospirosis in pregnancy: Prevalence and outcome

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Original Article

Author Details : Iram Rafique*, Fatima Khan, Tamkin Rabbani, Syed Mohd Kamil Ashraf, Md Mahtab

Volume : 6, Issue : 4, Year : 2019

Article Page : 516-521

https://doi.org/10.18231/j.ijogr.2019.111

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Abstract

Introduction: Leptospirosis is considered as most widespread zoonotic disease in the world. Infection
in pregnant women may be grave leading to severe fetal and maternal mortality. The presentation may
mimic other viral, bacterial and parasitic infections, acute fatty liver, pregnancy-induced hypertension, and
HELLP syndrome.
Objective: Diagnosis of Leptospirosis by ELISA and multiplex PCR for sec Y genes in antenatal patients
with fever of 15 days duration and to assess the prevalence of Leptospirosis in the pre-determined group.
To compare outcome of pregnancy in the predetermined groups.
Materials and Methods: The study was conducted in the Department of Microbiology and Department of
Obstetrics and Gynaecology and necessary required expertise from the Department of Medicine, JNMCH,
AMU for a period of 3 years, from September 2016 to August 2018.
Pregnant females attending the Antenatal Clinic during 9 months of pregnancy were included in the study
and followed for fetal outcome.
Laboratory diagnosis of leptospirosis was done by IgM ELISA Pan BIO and MULTIPLEX PCR for Sec Y
genes.
Result: In our study ELISA test was performed on 130 suspected antenatal female patients for
Leptospirosis. It was observed that out of 130 cases, ELISA was reactive in 14 (10.76) patients and nonreactive
in 116 (89.23) patients while none of the patient in control was reactive by ELISA. Patients were
followed for outcome of pregnancy. Most of the patients delivered by vaginal route 7 (50%), 3 (21.42%)
underwent cesarean section, 3 (21.42%) cases had abortion and 1 (7.14%) patient gave stillbirth. Birth
weight of live babies born to antenatal females suspected of Leptospirosis categorised into 0 (0%) babies
were Extremely Low Birth Weight (ELBW) (<1> 3 (30%) were Low Birth Weight(LBW) (<2> (10%) Large for Gestational Age (LGA) (4 kg).
Conclusion: The hazards of leptospirosis during pregnancy include intrauterine infection with fetal
death and abortion, stillbirth, premature labour and signs of congenital leptospirosis within a week or
two of delivery and unwanted complications like pregnancy induced hypertension, hypertension, HELLP
syndrome leading elective caesarean section.

Keywords: Leptospirosis, Risk Factors, Prevalence, Pregnancy, Fetal Outcome.

How to cite : Rafique I , Khan F, Rabbani T, Ashraf S M K, Mahtab M , Leptospirosis in pregnancy: Prevalence and outcome. Indian J Obstet Gynecol Res 2019;6(4):516-521

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