Enfermedad parecida a Chikungunya en 12 embarazadas del Hospital Universitario de Caracas (HUC) Venezuela. Año 2014

Resumen

Introducción: La fiebre chikungunya es causada porel virus Chikungunya, emergente en las Américas desdefinales del año 2013, y transmitida principalmente porAedes aegypti y A. albopictus. Las gestantes puedenser afectadas, así como su progenie.Objetivo: Presentar las características epidemiológicasy clínicas de una enfermedad parecida a chikungunyaen embarazadas evaluadas en el Hospital Universitariode Caracas (HUC).Método: Estudio retrospectivo y descriptivo, realizadodesde agosto hasta noviembre de 2014 y analizadocon el programa epi-info 7.Resultados: Se incluyeron 12 casos, 9 de cuidadosambulatorios y 3 hospitalizadas, rango de edad de 19a 37, (promedio 28) años de edad, 50 % en el primertrimestre, 75 % multíparas. Comorbilidad asociada en3 pacientes: VIH, una paciente; displasia de cadera,una; hipertensión arterial y diabetes gestacional, una.Otras condiciones: bacteriuria asintomática, dospacientes; candidiasis genital, una. Tres pacientesfueron hospitalizadas entre 1 a 33 días debido a :artritis en rodilla, diabetes gestacional e hipertensiónarterial, y enfermedad atípica, un caso cada una. Nose observaron complicaciones obstétricas. Síntomasmás frecuentes: artralgias (100.%), fiebre (75.%),rash (75.%), artritis/sinovitis (33 %), cefalea,adenomegalias cervicales e incapacidad para caminar(25 % cada una) y poliartralgias (25 %). Las artralgiasse presentaron con mayor frecuencia en manos y pies.La chikungunya atípica fue confirmada por PCR-TRen una embarazada de 19 años, y 20 semanas degestación. En el resto de las pacientes el diagnósticofue presuntivo.Conclusiones: La chikungunya puede causarenfermedad atípica, evolución adversa del embarazoy transmisión vertical.

Palabras clave: Chikungunya; Embarazadas; Epidemia

SUMMARY

Introduction: Chikungunya fever is a disease causedby the chikungunya virus, emergent in the Americassince the end of 2013, and it’s mainly transmitted byAedes aegypti and Aedes albopictus . Pregnant womencan be particularly affected, as well as their offspring.Objective: To demonstrate epidemiologic and clinicalcharacteristics of like disease to chikungunya inpregnant women evaluated in the Caracas UniversityHospital.Method: A retrospective and descriptive researchfrom august to november 2014, and analized withEpi-info 7 software.Results:. Twelve cases were included: Nineambulatory and three hospitalized cases, between19 to 37 (mean 28) years old, 50 % were in thefirst gestational trimester, 75 % were multiparous;associated comorbidities were on three patients: HIV 1,hip dysplasia 1, arterial hypertension and gestationaldiabetes 1; other conditions were: asymptomaticbacteriuria 2, and genital candidiasis 1. Threepatients were hospitalized from 1 to 33 days, withdiagnosis of: knee arthritis, gestational diabetes andarterial hypertension, and atypical disease, on eachcase. Obstetric complications were not observed. Themost frequent symptoms were: arthralgia (100 %),fever (75 %), rash (75 %), arthritis (33 %), headache,cervical adenomegaly and inability to walk 25 %each one. Arthralgia was more frequent in hands andfeet. Atypical chikungunya was observed in a 19 yearold with 20 weeks pregnancy. A chikungunya viraldiagnosis was confirmed in this patient by PCR-TR. Aclinical manifestations allow to diagnose chikungunyain other pregnant women.Conclusion: Chikungunya can cause atypical disease,adverse pregnancy outcomes and vertical transmission. Obstetric complications were not observed. Themost frequent symptoms were: arthralgia (100 %),fever (75 %), rash (75 %), arthritis (33 %), headache,cervical adenomegaly and inability to walk 25 %each one. Arthralgia was more frequent in hands andfeet. Atypical chikungunya was observed in a 19 yearold with 20 weeks pregnancy. A chikungunya viraldiagnosis was confirmed in this patient by PCR-TR. Aclinical manifestations allow to diagnose chikungunyain other pregnant women.Conclusion: Chikungunya can cause atypical disease,adverse pregnancy outcomes and vertical transmission.

Key words: Chikungunya; Pregnancy; Epidemic.