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Lee, Lee, and Kim: Maternal and Fetal Morbidities in Perinatal Measles Infection: A Case Report
Case Report

Korean J Perinatol 2015;26(2):128-133.

Published online: 20 June 2015

DOI: https://doi.org/10.14734/kjp.2015.26.2.128

Maternal and Fetal Morbidities in Perinatal Measles Infection: A Case Report

Hyun-Seung Lee, M.D.1, Eun-Kyoung Lee, M.D.1, Yeon Hee Kim, Ph.D.2

1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea

2Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to: Yeon Hee Kim, Ph.D. Department of Obstetrics and Gynecology, College of Medicine The Catholic University of Korea, Uijeongbu St. Mary's Hospital #271 Cheon Bo-Ro, Uijeongbu, Gyeonggi-do 480-717, Korea Tel: +82-31-820-3097, Fax: +82-31-847-2041 E-mail: yoni@catholic.ac.kr

Received 14 April 2015       Revised 8 June 2015       Accepted 9 June 2015

Copyright © 2015 Korean Society of Perinatology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Measles during pregnancy has been associated with deleterious effects on the perinatal outcomes. We encountered a case of perinatal measles infection during the 2013 measles outbreak in South Korea. The mother experienced severe gestational measles associated with the lack of vaccination. She had a preterm delivery and the neonate developed congenital measles, which was diagnosed based on the results of serological tests for the mother and neonate. Herein, we described the case, first reported with confirmed transplacental transmission in Korea to our best knowledge, and also reviewed relevant literature regarding measles during pregnancy, which suggested that perinatal measles and the outcomes are markedly influenced by the status of maternal immunity during prenatal period.

Keywords: Measles, Pregnancy, Maternal-fetal infection transmission

References

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Fig. 1.
Bilateral pneumonic infiltration with pleural effusion of both lung fields in the mother on the 3rd hospital day.
kjp-26-128f1.tif
Fig. 2.
Diffuse multiple maculopapular rashes on the right arm and shoulder, and the upper trunk of the mother on the 4th hospital day.
kjp-26-128f2.tif
Table 1.
Data from the literature regarding cases of measles during pregnancy in the past decade
Year References Number of cases Pregnancy and neonatal outcomes Maternal outcomes Comments
2009 Ohij, et al.8 1 Prematurity, congenital measles with skin rash Preterm delivery Japan; time between rash and delivery, 4 days; prophylactic immunoglobulin administered to the neonate
2010 Bar-on, et al.9 1 Abortion due to premature rupture of membranes at 16 weeks' gestation   Israel; identification of the virus in the placental tissue
2010 Go, et al.10 1 Prematurity, no evidence of congenital measles Preterm delivery Japan; time between rash and delivery, 1 day; prophylactic immunoglobulin administered to the neonate
2012 Huoi et al.1 13 1 preterm delivery 6 (46%) cases requiring hospitalization, 4 (31%) pneumonia cases French; 2010–2011 outbreak in Lyon
2012 Peruzzo, et al.11 1 Congenital measles with skin rash   Switzerland; time between rash and delivery, 0 day; prophylactic immunoglobulin administered to the neonate
2014 Ali, et al.6 61 Of total 53 deliveries, 40 (75.5 %) term deliveries, 6 (11.3%) abortions, 4 (7.5%) preterm births, 3 (5.7%) stillbirths 11 maternal deaths (18.0%; pneumonia (n=9), encephalitis (n=1), and intracranial hemorrhage (n=1); including 8 during the prenatal period), 35 (57.4%) illiteracy Sudan; 46 (75.4%), no prenatal care; 12 (19.7%), vaccinated; 32 (52.5%), not vaccinated; 17 (27.8%), vaccine status not known
2013 Giusti, et al.7 2 2 cases of prematurity, 2 asymptomatic congenital measles cases Preterm delivery France; time between rash and delivery, 14 and 3 days, respectively; prophylactic immunoglobulin administered to 1 neonate
2014 Ogbuanu, et al.12 55 Of a total of 42 known fetal or neonatal outcomes, 7 (16.7%) spontaneous abortions, 4 (9.5%) IUFD, 9 (21.4%) cases of prematurity; Of the 31 live births, 3 (9.7%) neonatal mortalities; Of 18 with known birth weight, 7 (38.9%) newborns with low birth weights 33 (60%) diarrhea, 22 (40%) pneumonia, 3 (5%) encephalitis, 5 (9.3%) maternal mortality; Of 42 with available data of hemorrhage, 3 (7.1%) excessive hemorrhage cases Namibia; 2009–2010; retrospective case-control study
2014 Casalegno, et al.13 13 1 (7.7%) prematurity 11 (84.6%) fever cases, 4 (30.8 %) pneumonia cases French; 2011 outbreak in Lyon
Present case   1 Prematurity, congenital measles with skin rash Preterm delivery, pneumonia, enteritis, hepatitis South Korea; time between rash and delivery, 1 day; prophylactic immunoglobulin administered to the neonate

Abbreviation: IUFD, intrauterine fetal death

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