Document Type

Case Study


School of Nursing and Midwifery, Pakistan


Dengue is the arthropod-borne flavivirus infection, its severity increases during pregnancy, and results in worst maternofetal outcomes, which is an alarming issue. Dengue fever (DF) is the most common cause for preterm delivery and abortion. Dengue-related thrombocytopenia increases the risk of bleeding during pregnancy and delivery and can also leads to high maternal mortality rates. Globally 3.9 billion people are at risk of dengue fever, especially in Asia.
This case study focuses on a 22-years old pregnant woman from Pakistan without known co-morbidities. She presented in an emergency department with high fever, nausea, vomiting, and bleeding gum. She was positive for dengue and malaria. Due to the emergence of warning sign and symptoms, rapidly decreasing platelets, deranged coagulopathy, liver and renal profile, the baby was delivered by spontaneous vaginal delivery. The woman went into post-partum hemorrhage (PPH), and due to concealed bleeding needed multiple transfusions, vaginal packaging, and balloon tamponade. She developed multiple organ failure and was on continuous renal replacement therapy (CRRT). On day eight in intensive care unit, life support was withdrawn at the family’s request, and she died.
This case report of a failure to safe a pregnant woman’s life highlights the importance of being alert to early warning signs, establishing an early diagnosis, timely interventions, close monitoring, and critical consideration of physiological changes of pregnancy are important for diagnosing infectious diseases such as dengue and malaria early, especially when both infections happen at the same time. In this case the baby survived but the woman sadly died.