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      • Poster Session : PS 0403 ; Infectious Disease ; Early Identifi cation of Plasma Leakage in Pregnant Dengue Patients

        ( Priyankara Jayawardena ),( Gaveshika Abeyrathne ),( Damayanthi Idampitiya ),( Deshapriya Ananda Wijewickrama ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Dengue Haemorrhagic Fever (DHF) is the commonest complication in Dengue. Early identifi cation of plasma leakage in DHF is very important to prevent patients from going into shock. Rising haematocrit (HCT) is the commonest parameter used to detect DHF. However, no data is available for dengue in pregnancy. Methods: Retrospective observational study was conducted on all pregnant Dengue patients admitted to two hospitals in Colombo during 2013 to identify parameters useful in diagnosing DHF. Dengue infection was confi rmed by positive serology; DHF by Ultra Sound Scan (USS). Results: 58 qualifi ed for the study. Mean age was 28.45(SD: 5.573) yrs. 32(55.2%) had Dengue fever (DF) while 26(44.8%) had DHF. All had fever. 86.2% had myalgia. Hepatic tenderness, persistent vomiting and postural dizziness were commoner with DHF (81.8%, 100% & 70% respectively). Temperature, pulse rate and urine output had no signifi cant differences between DF and DHF. The mean lowest platelet count in DF was 90.94 while in DHF was 37.81 (p<0.000). Both AST and ALT levels were higher in DHF. PT/INR (6.8%) and APTT (8.6%) were elevated in both DF & DHF. Of the 32 DF patients, 19 (59%) had HCT rise of <10%, and other 13(40.6%) had HCT rises between 11% to 19%. Of the 26 DHF patients, 3 (11.5%) had HCT rise of <10%, 12 (46.2%) had HCT rises between 11% to 19% while 11 had HCT rise of >20%. Only one patient went into shock. All patients recovered fully. Conclusions: Lower platelet count and higher ASOT & ALT were in favour of DHF. HCT changes are helpful to diagnose DHF only when it is >20%. However, lesser changes don`t exclude the possibility of DHF. Hence, we recommend that USS should be used routinely in all pregnant patients to diagnose DHF.

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